Emergency medicine journal : EMJ
-
Randomized Controlled Trial Comparative Study
Comparison of manikin versus porcine models in cricothyrotomy procedure training.
To compare the usefulness for training of a porcine model (larynx, trachea, and pig skin) and a manikin model using a Portex cricothyrotomy kit (PCK). ⋯ The porcine model is a more useful training tool than the manikin model for cricothyrotomy with PCK because of its reality and similarity to human anatomy.
-
To clarify the relationship between presenting clinical condition and blood alcohol concentration (BAC) among adult patients admitted to a resuscitation room (RR) of an emergency department (ED) in order to help guide clinical practice. ⋯ The following five presentations to the RR are associated with a positive BAC: collapse from alcohol/drugs, self-harm, trauma, gastrointestinal bleeding (ICD-10 code K92.2) and non-cardiac chest pain (ICD-10 code R07). Patients with a positive BAC demonstrate a very wide range of pathology, some with severe levels of misuse. This highlights the opportunity for prompt feedback when sober, to ensure all is done to encourage patients to contemplate change in order to reduce re-attendance.
-
Dural sinus thrombosis (DST) has an annual incidence of 3-4 per million and can result from many aetiologies. Presentation of the disease can vary considerably, as can the aetiology and delay of symptoms to clinical detection. Symptoms on presentation include headache, seizures, focal neural deficits and altered mental status. ⋯ Internal jugular vein thrombosis is also a rare disease and as with DST, traumatic aetiologies are uncommon. More common aetiologies include iatrogenic causes related to catheterisation as well as infectious causes (eg, Lemierre's syndrome). A case of thrombosis of the transverse sinus, sigmoid sinus and internal jugular vein associated with a closed head injury as the result of a motorcycle accident is presented.
-
Nitrous oxide (N(2)O) is an attractive agent for procedural analgesia and sedation of children in the emergency department (ED). Despite increasing use, efficacy data for painful procedures are limited. This study aimed to determine pain scores during ED procedural sedation with N(2)O in the ED setting. ⋯ Data indicate that parents and staff are generally satisfied with N(2)O for procedural use in the ED. The efficacy of N(2)O as a sole agent in very painful procedures is limited.
-
Earlier studies have shown that the laryngeal mask airway (LMA) is an effective alternative method for the administration of drugs. The pharmacological effect of drug administration via the LMA in cardiac arrest is still unknown. This study was designed to compare the effect of epinephrine administration tracheally or through the LMA in an asphyxial resuscitated porcine model. ⋯ Drug administration from a catheter through the LMA into the trachea achieved comparable PE levels to those achieved by the tracheal route. Epinephrine administered via the LMA catheter may be an acceptable alternative to treat asphyxial cardiac arrest.