Emergency medicine journal : EMJ
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To determine the frequency of use of the terms "accident and emergency" and "emergency medicine" and their derivatives in original articles in the Journal of Accident and Emergency Medicine. ⋯ The use of emergency medicine to describe the specialty in the United Kingdom is increasing, although this may reflect the Journal's growing international standing. This trend should be taken into account in the debate over the specialty's name in this country.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intravenous ketamine plus midazolam is superior to intranasal midazolam for emergency paediatric procedural sedation.
This study compared intranasal midazolam (INM) with a combination of intravenous ketamine and intravenous midazolam (IVKM) for sedation of children requiring minor procedures in the emergency department. ⋯ Intravenous ketamine plus midazolam used in an appropriate setting by experienced personnel provides an excellent means of achieving sedation suitable for most non-painful minor procedures for children in the emergency department. This combination is superior to INM in terms of speed of onset and consistency of effect. INM delivered via aerosol spray has a more variable effect but may still be adequate for the completion of many of these procedures.
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To determine if there were differences in practice or intubation mishap rate between anaesthetists and accident and emergency physicians performing rapid sequence induction of anaesthesia (RSI) in the prehospital setting. ⋯ RSI performed by emergency physicians was not associated with a significantly higher failure rate or an increased number of intubation mishaps than RSI performed by anaesthetists. Emergency physicians were able to safely administer sedative and neuromuscular blocking drugs in the prehospital situation. It is suggested that emergency physicians can safely perform rapid sequence induction of anaesthesia and intubation.
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Advanced Trauma Life Support (ATLS) courses teach a system for the initial assessment and management of trauma patients that aims to optimise initial care and reduce mortality and morbidity, and have been adopted worldwide. This questionnaire survey characterised those who took up this particular educational resource in Scotland during a four year period after its introduction, and analysed how they felt it had affected their clinical competence. Irrespective of their previous level of training and experience, nearly all surgeons and anaesthetists who took this course felt that it had improved their clinical skills and other professional attributes. The significance of these results is discussed in the context of postgraduate surgical and anaesthetic training in Scotland.