Emergency medicine journal : EMJ
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Tracheal intubation is often difficult in the prehospital setting, especially in trapped casualties, when long extrication time is anticipated and conventional laryngoscopy cannot be achieved. The aim of the present study was the comparison of applicability and efficacy of two alternative techniques: intubation using a laryngeal mask airway (ILMA) or an Airtraq laryngoscope in different patient positions, using an airway management manikin. ⋯ These preliminary data in manikins could indicate the applicability of the methods to the prehospital setting.
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Randomized Controlled Trial Comparative Study
Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department.
To compare the clinical effectiveness of intravenous paracetamol with intravenous morphine in patients with moderate to severe traumatic limb pain. ⋯ Intravenous paracetamol appears to provide a level of analgesia comparable to intravenous morphine in isolated limb trauma. Further larger studies are required.
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Emergency medicine in The Netherlands is faced with an increasing interest by politicians and stakeholders in health care. This is due to crowding, increasing costs, criticism of the quality of emergency care, restructuring of out-of-hours services in primary care and the introduction of a training programme for emergency physicians in 2000. A comprehensive search was conducted of published research, policy reports and updated Dutch websites on acute care. ⋯ Although this seems an important step, it does not necessarily imply a good position of the emergency physician in the ED. What the characteristics of the future patient of the Dutch ED will be is dependent on the development of different ED levels of care and GP cooperatives. The lack of empirical research also points out the need for research on quality of care in Dutch ED.
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Emergency Care Practitioners (ECPs) are operational in the UK in a variety of emergency and urgent care settings. However, there is little evidence of the effectiveness of ECPs within these different settings. The aim of this study was to evaluate the impact of ECPs on patient pathways and care in different emergency care settings. ⋯ ECPs have a differential impact compared with usual care providers dependent on the operational service settings. Maximal impact occurs when they operate in mobile settings when care is taken to the patient. In these settings ECPs have a broader range of skills than the usual care providers (eg, paramedic), and are targeted to specific clinical groups who can benefit from alternative pathways of care (such as older people who have fallen). Trial Registration No ISRCTN22085282 (Controlled trials.com).