The American journal of emergency medicine
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Letter Randomized Controlled Trial Comparative Study
Comparison of two intravascular access techniques when using CBRN-PPE: A randomized crossover manikin trial.
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Observational Study
A quick and easy delirium assessment for nonphysician research personnel.
Delirium in the emergency department (ED) is an emerging field of research. Most ED research infrastructures utilize lay personnel to collect data, but delirium assessments that can be reliably performed by nonphysicians are lacking. We evaluated the diagnostic performance of the modified Brief Confusion Assessment Method (modified bCAM) for this purpose. ⋯ The modified bCAM may be a feasible and accurate method for nonphysicians to assess for delirium. Future studies are needed to confirm these findings.
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Multicenter Study Observational Study
Effectiveness of glucagon in relieving esophageal foreign body impaction: a multicenter study.
Glucagon is thought to decrease lower esophageal sphincter tone and is used as an alternative to invasive endoscopy for esophageal foreign body impaction (EFBI). The purpose of this study was to evaluate efficacy and safety of glucagon and identify characteristics associated with success. ⋯ Glucagon-related resolution occurred in 14.2% of patients and was not significantly different compared with those that did not receive glucagon (10.3%). Concomitant medication administration was associated with lower success. Overall, glucagon had a low success rate, was related to adverse effects, and does not offer advantages for treatment.
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Spontaneous visceral artery dissection (VAD) is a rare disease that mainly occurs in the superior mesenteric artery and celiac artery. However, VAD has been detected more frequently in the past several years because of the increasing use of computed tomography (CT) for the evaluation of abdominal symptoms. A prompt diagnosis and referral to a specialist should be made, because VAD occasionally causes critical bowel ischemia. However, there is no well-established management approach. We performed a retrospective analysis to evaluate the characteristics and prognoses of patients diagnosed with VAD. ⋯ Patients with VAD often present with sudden onset abdominal pain. Most patients were managed successfully with conservative treatment. No fatal cases were observed; however, some cases were missed, even with an enhanced CT scan. It is necessary to include VAD among the differential diagnoses of acute abdominal pain. Patients with VAD should be referred to a specialist, because this disease occasionally causes critical bowel ischemia, necessitating surgical intervention.
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Observational Study
Tracheal ultrasonography and ultrasonographic lung sliding for confirming endotracheal tube placement: Faster? Reliable?
In this study we aimed to evaluate the success of ultrasonography (USG) for confirming the tube placement and timeliness by tracheal USG and ultrasonographic lung sliding in resuscitation and rapid sequence intubation. ⋯ Ultrasonography achieved high sensitivity and specificity for confirming tube placement and results faster than end-tidal carbon dioxide. Ultrasonography is a good alternative for confirming the endotracheal tube placement. Future studies should examine the use of ultrasonography as a method for real-time assessment of endotracheal tube placement by emergency physicians with only basic ultrasonographic training.