The American journal of emergency medicine
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Serotonin syndrome is a rare, frequently misdiagnosed, serious condition with high morbidity. ⋯ An understanding of serotonin syndrome can assist emergency clinicians in diagnosing and managing this disease.
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Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases and expanding knowledge of this has prompted a need for a focused review for practicing clinicians. ⋯ An understanding of the presentation, evaluation, and management of monkeypox is essential for emergency clinicians to ensure appropriate diagnosis and treatment of this emerging disease.
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A recent academic-government partnership demonstrated the feasibility of utilizing Emergency Departments (ED) as a primary site for subject enrollment in clinical trials and achieved high rates of recruitment in two U.S. EDs. Given the ongoing need to test new therapeutics for influenza and other emerging infections, we sought to describe the historical rates of participant recruitment into influenza Phase III therapeutic RCTs in various clinical venues, including EDs. ⋯ Published RCTs evaluating influenza therapeutics in clinical settings recruit participants from multiple sites but enroll relatively few participants, per site, per season. The few ED-based studies reported recruited more subjects per site per season. Untapped opportunities likely exist for EDs to participate and/or lead therapeutic RCTs for influenza or other emerging respiratory pathogens.
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Multicenter Study
Trauma associated with cardiopulmonary resuscitation based on autopsy reports after the 2015 ERC guidelines.
Cardiopulmonary resuscitation (CPR)-related injuries have not been assessed since the 2015 Resuscitation Guidelines were established. ⋯ CPR-related injuries occurred frequently, although those that were life-threatening accounted for only 3% of cases. There were no differences between patients who were resuscitated by bystander(s) or by professionals and no differences between mechanical chest devices or manual resuscitation. Compared with a study based on the 2010 guidelines, similar injuries were found, but with more rib fractures, less visceral organ damage, and fewer life-threatening injuries.
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Randomized Controlled Trial
Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound.
Studies on ocular point-of-care ultrasound vary on whether gel should be directly applied to the eye or on top of an adhesive membrane (i.e., Tegaderm™). However, there are currently no data regarding which approach has better image quality and the impact of patient preference. In this study, we sought to address this gap by assessing the difference in image quality and patient preference between Tegaderm™ versus no Tegaderm™ for ocular ultrasound in the emergency department. ⋯ Tegaderm™ was associated with reduced image quality and no significant difference in patient discomfort when utilized for ocular ultrasound. This study suggests that ocular ultrasound may be better performed without the use of Tegaderm™. Future research should evaluate the impact of Tegaderm™ vs. no Tegaderm™ among more novice users.