Emergency medicine journal : EMJ
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Point-of-care echocardiography using portable machines is an exciting development in emergency medicine. Recent improvements in ultrasound quality mean that emergency physicians are finding echocardiography useful in a variety of clinical settings. ⋯ Patients with clinical conditions such as breathlessness, undifferentiated shock, chest pain and cardiac arrest may benefit. There is a steep learning curve involved in acquiring these skills and the specialty needs to take care in the way that its practitioners are accredited and perform echocardiography.
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Randomized Controlled Trial
The usefulness of the GlideScope video laryngoscope in the education of conventional tracheal intubation for the novice.
The aim of this study is to evaluate the usefulness of the GlideScope video laryngoscope (GVL) as a tool to educate novice users in conventional tracheal intubation. 41 premedical students with no previous experience in tracheal intubation participated in this prospective, randomised and controlled study. Group M (n = 20) was instructed in tracheal intubation by using the Macintosh laryngoscope and group G (n = 21) was instructed by using both the GVL and the Macintosh laryngoscope. ⋯ This aspect makes the trainee feel more comfortable learning the material with a high degree of satisfaction. Introducing GVL to conventional intubation education for novice users could increase the satisfaction of trainees during the procedure, especially as a way to understand critical anatomical structures.
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The thrombolysis in myocardial infarction (TIMI) risk score has been shown to risk stratify patients with suspected acute coronary syndromes (ACS) effectively in the emergency department (ED) but cannot be used to guide patient disposition. We aimed to evaluate whether modifying the TIMI risk score to give greater weighting to ischaemic ECG changes and troponin elevations would enhance its risk stratification and thus potentially facilitate safe patient discharge after 12-h troponin testing. ⋯ Modifications to the TIMI risk score can improve its performance in the risk stratification of patients presenting to the ED with chest pain. However, a lack of specificity may still limit its use for guiding patient disposition after troponin testing.
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Comparative Study
Ambulance call triage outcomes for patients reporting pain: a retrospective cross-sectional analysis of pain score versus triage level.
To identify any association between the response priority code generated during calls to the ambulance communication centre and patient reports of pain severity. ⋯ The severity of pain experienced by the patient appeared to have no influence on the priority (urgency) of the dispatch response. Triage systems used to prioritise ambulance calls and decide the urgency of response or type of referral options should consider pain severity to facilitate timely and humane care.