Emergency medicine journal : EMJ
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Endotracheal intubation (ETI) is a commonly performed but potentially high-risk procedure in the emergency department (ED). Requiring more than one attempt at intubation has been shown to increase adverse events and interventions improving first-attempt success rate should be identified to make ETI in the ED safer. We introduced and examined the effect of a targeted bundle of airway initiatives on first-attempt success and adverse events associated with ETI. ⋯ This bundle of airway management initiatives was associated with significant improvement in the first-attempt success rate of ETI. The introduction of a regular education programme based on the audit of a dedicated airway registry, combined with a periprocedure checklist is a worthwhile ED quality improvement initiative.
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A short cut review was carried out to whether the FAST screening tool is more accurate than the ROSIER tool at correctly identifying those with stroke in the prehospital setting. 9 papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that FAST and ROSIER have similar sensitivities in the recognition of stroke, with ROSIER demonstrating a higher specificity in the prehospital setting.