Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2010
ReviewReview article: Safety profile of propofol for paediatric procedural sedation in the emergency department.
The use of propofol for paediatric procedural sedation (PPS) is increasing because of its favourable pharmacodynamic profile. Its paediatric use has been limited in some ED (emergency departments) because of the perceived high rate of serious adverse events in comparison with other sedation agents. A systematic literature review of propofol use for PPS outside the operating theatre environment from 1966 to 2008 was carried out to profile the adverse event rate in comparison with other procedural sedation agents. ⋯ The use of propofol for PPS is associated with a low rate of minor adverse events that are all reversible with minimal intervention and do not produce long-term sequelae and occur at similar rates to minor adverse events experienced with other sedation agents. Major adverse events with propofol sedation are extremely rare and appropriate patient and procedure selection would decrease these risks further. The increasing use of propofol for ED PPS is supported by the current evidence because of its comparable adverse event rate to other agents.
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Emerg Med Australas · Aug 2010
Randomized Controlled TrialBlood withdrawn through a cannula valve connector does not result in clinically significant haemolysis.
To assess the impact of cannula valve connectors on haemolysis of blood samples drawn from newly inserted cannulae. ⋯ The attachment of a cannula connector valve to a peripheral cannula prior to blood sampling is not associated with an increase in the rate of haemolysis or hyperkalaemia.
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Emerg Med Australas · Aug 2010
Emergency physician credentialing for resuscitative thoracotomy for trauma.
A low case incidence and variable skill level prompted the development of a credentialing programme and specific surgical training in resuscitative thoracotomy for emergency physicians at The Alfred, a Level 1 Adult Victorian Major Trauma Service. ⋯ Emergency physicians working in high-volume Trauma Centres are expected to diagnose cardiac tamponade and on occasion decompress the pericardium. Specific training in the procedure should be undertaken.