The American journal of emergency medicine
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Review Meta Analysis
Chemical agents for the sedation of agitated patients in the ED: a systematic review.
Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. ⋯ Combination therapy sedated a greater proportion of patients at 15-20 minutes than benzodiazepines alone. Antipsychotics and combination therapy were more effective, requiring less repeat doses for sedation than benzodiazepines. The risk of any adverse event was higher with benzodiazepines.
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Review Meta Analysis
Chemical agents for the sedation of agitated patients in the ED: a systematic review.
Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. ⋯ Combination therapy sedated a greater proportion of patients at 15-20 minutes than benzodiazepines alone. Antipsychotics and combination therapy were more effective, requiring less repeat doses for sedation than benzodiazepines. The risk of any adverse event was higher with benzodiazepines.
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Review Meta Analysis
Optimal wrist positioning for radial arterial cannulation in adults: A systematic review and meta-analysis.
Wrist extension is commonly taught as part of the radial artery cannulation technique. Currently the degree of wrist extension required to optimize cannulation success remains inconclusive. This is the first meta-analysis to investigate optimal wrist positioning for radial artery cannulation. ⋯ This review found moderate evidence in support of a 45° wrist angulation to facilitate arterial cannulation, however the results are largely limited by the external validity of the data collected given the restrictive populations studied. Any further studies investigating the effect of altering wrist angulation on radial artery cannulation should focus on populations who are either likely to require arterial cannulation or predisposed to difficult access.
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This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. ⋯ The use and implementation of SOPs and checklists in prehospital emergency medicine have shown some benefits of improving guidelines adherence and patient outcomes in airway management, patient records, identification and triage, and other prehospital interventions. More research in this area is necessary to optimize the future use and implementation of SOPs and checklists to improve emergency personnel performance and patient outcomes.