Emergency medicine journal : EMJ
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Randomized Controlled Trial Comparative Study
Recovery from sedation with remifentanil and propofol, compared with morphine and midazolam, for reduction in anterior shoulder dislocation.
To compare recovery from sedation using remifentanil and propofol with our standard regimen of morphine and midazolam for closed reduction in shoulder dislocation in an ED. ⋯ Remifentanil and propofol reduces patient recovery time and provides equivalent operating conditions compared with morphine and midazolam for the reduction of anterior glenohumeral dislocation.
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Comparative Study
Infections in crush syndrome: a retrospective observational study after the Wenchuan earthquake.
To investigate the characteristics of infections in the casualties with crush syndrome after the Wenchuan earthquake. ⋯ Infectious complications are common in crush syndrome. In order to improve patient outcomes, vigorous care and strict surveillance are required.
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The aim of this study was to determine whether medical students working with the same attending on multiple shifts as opposed to a variety of attendings leads to the performance of more procedures during their emergency medicine (EM) elective. ⋯ Medical students that worked four or more shifts with a single EM attending performed twice as many overall procedures (12.9 vs 6.3) and significantly more invasive procedures than medical students who worked with a variety of attendings during their 4th-year EM elective.
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Falls are recognised as a major public health issue, particularly among older people, and have been targeted for attention by national service frameworks and National Institute for Health and Clinical Excellence guidelines in the UK. However, reliable epidemiological data are not easily available, and it remains difficult to monitor the effect of interventions that seek to reduce the public health impact of falls. ⋯ This study describes a simple way for ED to establish routine falls surveillance. It offers the first estimate of the impact of falls on ED in the UK, suggesting that such services are dealing with 4 million falls-related attendances every year.
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Comparative Study
No relationship between measures of clinical efficiency and teaching effectiveness for emergency medicine faculty.
Emergency medicine (EM) doctors affiliated with academic institutions experience professional tension between providing excellent, timely care for patients and high-quality bedside instruction for residents and medical students. The goal of this study was to assess the relationship between measures of faculty clinical efficiency and teaching effectiveness. ⋯ These data replicate previous findings that clinical productivity has no correlation with teaching effectiveness for emergency medicine faculty doctors.