Emergency medicine journal : EMJ
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Comparative Study
Securing the prehospital airway: a comparison of laryngeal mask insertion and endotracheal intubation by UK paramedics.
The recent introduction of a disposable laryngeal mask airway has provided paramedics with an alternative to endotracheal intubation. Time taken to secure the airway with each device was compared in patients undergoing elective surgery. ⋯ Even under optimal conditions, 30% of attempts at intubation by paramedics were unsuccessful. A disposable laryngeal mask has a higher success rate in securing the airway and overall, secures the airway more reliably than endotracheal intubation.
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A short cut review was carried out to establish whether intubation is always required in patients presenting with a decreased conscious level after gamma-hydroxybutyrate ingestion. Altogether 95 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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Comparative Study
Changes in the emergency workload of the London Ambulance Service between 1989 and 1999.
To examine changes in the emergency workload of the London Ambulance Service (LAS) between 1989 and 1999. ⋯ Demand for emergency ambulance services in London has doubled in a decade. This increase is similar for all age groups, with no evidence of a greater rise in demand among older people. Call rates have increased more steeply in men than in women. Demographic changes do not explain the observed increases in demand.
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Comparative Study
The efficacy of structured assessment and analgesia provision in the paediatric emergency department.
To ascertain if the use of a structured pain assessment tool and nurse initiated oral analgesia protocols improve uptake and time to analgesia for children presenting to the emergency department with minor or moderate musculoskeletal injuries. ⋯ The use of a nurse initiated, oral analgesia protocol for treatment of children with mild to moderate injury can significantly increase analgesia provision rates and decrease time to provision of analgesia.
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This review examines the present understanding of tension pneumothorax and produces recommendations for improving the diagnostic and treatment decision process.