Annals of emergency medicine
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Clinical Trial Controlled Clinical Trial
Incision and drainage of cutaneous abscesses is not associated with bacteremia in afebrile adults.
To determine the prevalence of bacteremia associated with incision and drainage (I&D) of cutaneous abscesses in afebrile adult emergency department patients. Such information has implications for the ED management of immunocompromised patients, patients with history of endocarditis, and patients with prosthetic appliances such as heart valves and artificial joints. ⋯ I&D of localized cutaneous abscesses in afebrile adults is unlikely to result in transient bacteremia. Larger studies are needed to determine whether routine antibiotic prophylaxis is necessary for afebrile patients undergoing I&D.
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We conducted a pilot study to assess the feasibility of ultrasonography in the detection of traumatic complications of CPR. ⋯ Traumatic complications of CPR are well known but typically difficult to assess. Ultrasonography may identify injuries, help guide procedures, and serve as a means to assess pharmacologic effects on cardiac performance during CPR. It is a readily available, noninvasive means to assess these critically ill patients.
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To determine whether abdominal ultrasound can be used routinely as the primary screening test to identify the need for laparotomy in trauma patients. ⋯ Ultrasound is a sensitive and specific test with which to evaluate trauma patients for abdominal injury requiring surgery. Routine abdominal ultrasound can be performed at the bedside in the emergency department as a timely, noninvasive diagnostic test. This use of a screening abdominal ultrasound examination can improve clinical decision-making for the use of emergency laparotomy. Ultrasound may be a better alternative to CT or diagnostic peritoneal lavage for the initial screening evaluation of abdominal trauma.
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Randomized Controlled Trial Clinical Trial
Ultrasound for the detection of foreign bodies in human tissue.
To determine the accuracy of detection of wood and plastic foreign bodies in human tissue by relatively inexperienced clinicians using typical ultrasound equipment. ⋯ Ultrasound is imperfect but may be useful in screening for superficial foreign bodies in human tissue. Clinical utility in the ED setting remains to be tested.
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Randomized Controlled Trial Clinical Trial
Real-time ultrasound-guided femoral vein catheterization during cardiopulmonary resuscitation.
To compare the use of real-time-ultrasound guidance with the standard landmark-oriented approach for obtaining femoral vein catheterization in patients requiring intravenous access during CPR. ⋯ Real-time ultrasound-guided femoral vein catheterization was faster and produced a lower rate of inadvertent arterial catheterization and a higher rate of success during CPR than the standard landmark-oriented approach. Also, ultrasound demonstrated that palpable femoral pulsation during CPR is venous rather than arterial.