Annals of emergency medicine
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Randomized Controlled Trial Comparative Study
Etomidate versus midazolam for procedural sedation in pediatric outpatients: a randomized controlled trial.
Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. ⋯ Induction and recovery times are shorter with etomidate compared with midazolam. At the dosages used for procedural sedation and analgesia among children with displaced extremity fracture, etomidate has higher efficacy in comparison with midazolam.
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Randomized Controlled Trial Comparative Study
"Should I give you my smoking lecture now or later?" Characterizing emergency physician smoking discussions and cessation counseling.
We determine frequency and manner in which emergency physicians address smoking with their patients. ⋯ Emergency physicians were likely to gather information about smoking but not to counsel or advise patients to quit. These results raise the question of whether emergency medicine resident training should include additional emphasis on smoking cessation counseling and motivational interviewing techniques.
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Regional health information organizations and electronic health information exchange may have an important impact on the practice of emergency medicine in the United States. Regional health information organizations are local or regional information-sharing networks that enable electronic data interchange among stakeholders in a given geographic area. ⋯ Because of the unique need for rapid access to information and the acuity of the clinical environment, few areas of the health care delivery system stand to change and benefit more from health information exchange than our nation's emergency departments. This article will explain the motivation for the development of regional health information organizations, identify some of the important issues in their formation, and discuss how their development might affect the practice of emergency medicine.
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Comparative Study
The impact of trauma activations on the care of emergency department patients with potential acute coronary syndromes.
Trauma systems improve the care of trauma patients; however, it is possible that prioritizing the emergency care of trauma patients might adversely affect other potentially ill patients requiring the same resources. We seek to determine whether the presence of a concurrent trauma activation negatively affects processes of care and outcomes for patients with potential acute coronary syndromes. ⋯ The presence of a concurrent trauma activation at the time of presentation of a patient with potential acute coronary syndrome was associated with an increased incidence of 30-day adverse cardiovascular events. Although trauma activations improve the care of trauma patients, they may be associated with a negative impact on the care of other patients requiring contemporaneous resources.