Emergency medicine journal : EMJ
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Randomized Controlled Trial Comparative Study
Comparison of the GlideScope video laryngoscope and Macintosh laryngoscope in simulated tracheal intubation scenarios.
To compare the GlideScope video laryngoscope (GVL) with the classic Macintosh laryngoscope in simulated airway scenarios of varying difficulty. ⋯ This study suggests that the GVL could be an option for airway management even by emergency physicians with little experience and no training in its use.
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Randomized Controlled Trial Multicenter Study
Mitigation of pain during intravenous catheter placement using a topical skin coolant in the emergency department.
Although intravenous (i.v.) line placement is a common procedure in the emergency department (ED), it is an uncomfortable experience for many patients. Topical analgesic agents are rarely used because they have long onsets of action and thereby cause unacceptable treatment delays. Cryoanaesthesia, the use of cooling agents to reduce pain, has been recognised for many years as a potential pain management strategy. The purpose of this study was to determine whether an instantaneous topical skin coolant spray reduces patient's pain during i.v. cannulation and represents a feasible alternative for cutaneous analgesia in the ED setting. ⋯ Our study failed to detect a difference in pain perception resulting from the pre-procedural application of a skin coolant associated with i.v. placement in the ED setting.
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Randomized Controlled Trial Comparative Study
Impact of oral dexamethasone versus placebo after ED treatment of migraine with phenothiazines on the rate of recurrent headache: a randomised controlled trial.
Evidence suggests that the rate of recurrent headache after treatment of migraine in the emergency department (ED) is high. The mechanisms for this are unclear, but neurogenic inflammation may play a role. There is conflicting evidence about whether adjuvant dexamethasone reduces the rate of recurrent headache. The aim of this study was to compare the rate of recurrent headache in patients with migraine randomised to receive a single dose of oral dexamethasone or placebo at discharge after treatment in the ED with intravenous phenothiazine. ⋯ A single oral dose of dexamethasone following phenothiazine treatment for migraine in the ED did not reduce the rate of recurrent headache. There is weak evidence for a possible benefit in the subgroup who present within <24 h of symptom onset. A multicentre trial to confirm this finding is warranted.
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Randomized Controlled Trial Comparative Study
Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation.
Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation techniques is poorly understood. ⋯ One year after a single episode of ventilation training, lay persons tended to hyperventilate; however, the degree of hyperventilation and resulting stomach inflation were lower when a mouth-to-mask or a face shield device was employed. Regular training is therefore required to retain ventilation skills; retention of skills may be better with ventilation devices.
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Randomized Controlled Trial Comparative Study
Tracheal intubation by non-anaesthetist physicians using the Airway Scope.
To evaluate the performance of the Airway Scope for tracheal intubation by non-anaesthetist physicians. ⋯ The Airway Scope may reduce the time to secure the airway and the incidence of failed tracheal intubation in novice laryngoscopists.