Emergency medicine journal : EMJ
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Randomized Controlled Trial
Randomised trial comparing the recording ability of a novel, electronic emergency documentation system with the AHA paper cardiac arrest record.
To evaluate the ability of an electronic system created at the University of Washington to accurately document prerecorded VF and pulseless electrical activity (PEA) cardiac arrest scenarios compared with the American Heart Association paper cardiac arrest record. ⋯ Compared with paper documentation, documentation with the electronic system captured 24% more critical information during a simulated medical emergency without loss in data quality.
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Identifying 'true stroke' from an emergency medical services (EMS) call is challenging, with over 50% of strokes being misclassified. In a previous study, we examined the relationship between callers' descriptions of stroke symptoms to the emergency medical dispatcher and the subsequent classification and prioritisation of EMS response. The aim of this subsequent study was to explore further the use of keywords by callers when making emergency calls, comparing stroke and non-stroke calls. ⋯ People who contact the EMS about non-stroke conditions rarely say stroke, limb weakness, speech problems or facial weakness. These words are more frequently used when people contact the EMS about stroke, although many calls relating to stroke patients do not mention any of these keywords.
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Pain management in emergency departments (ED) is often inadequate despite the availability of effective analgesia, with many patients receiving insufficient and untimely analgesia. We conducted a systematic literature review to identify interventions that could improve pain management in the ED. ⋯ Many interventions reported improvements in pain management, but current evidence is insufficient to recommend any for widespread adoption. In order to improve pain management we need to understand more about the theory underlying interventions, the context in which interventions work, and develop interventions based on this stronger theoretical understanding.
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Randomized Controlled Trial
Comparison of intubation modalities in a simulated cardiac arrest with uninterrupted chest compressions.
Interruptions in chest compressions during cardiopulmonary resuscitation can negatively impact survival. Several new endotracheal intubation (ETI) techniques including video laryngoscopy may allow for ETI with minimal or no interruptions in chest compressions. We sought to determine the impact of three different ETI techniques upon time to intubation (TTI) in a simulated cardiac arrest during uninterrupted chest compression. ⋯ In this simulated model of cardiac arrest with uninterrupted chest compressions, TTI was shorter for GVL than DL while use of the GVL with bougie resulted in longer TTI.
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to determine the efficacy of the fascia iliaca block in providing analgesia to patients with a proximal femoral fracture in the emergency department. ⋯ the fascia iliaca block could have an important role in first-line pain control for patients presenting to the emergency department with a proximal femoral fracture. There is potential to reform the acute management of this common group of patients.