The American journal of emergency medicine
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Colonoscopy is a common procedure used for screening, diagnosis, and treatment of gastrointestinal disease. Life-threatening complications are uncommon (28/10 000 procedures) but include perforation, hemorrhage, diverticulitis, and postpolypectomy syndrome. Although previously reported, the association between appendicitis and colonoscopy is not widely known. ⋯ Although establishing causality is difficult, there is an association between colonoscopy and appendicitis, which may be underreported with literature-based estimates as high as 3.8 appendicitis cases per 10 000 procedures. Timely diagnosis of postcolonoscopy appendicitis may prove challenging given limited knowledge of this association between colonoscopy and appendicitis and similarity of presentation with other more well-known complications. This case report demonstrates that a recent history of colonoscopy should not preclude consideration of a traditionally broad differential diagnosis for abdominal pain, including appendicitis.
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Knowledge of current areas of activity in emergency medicine research may improve collaboration among investigators and may help inform decisions about future research priorities. Randomized, controlled trials are a key component of research activity and an essential tool for improving care. We investigated the characteristics of randomized trials recently published in emergency medicine journals. ⋯ Emergency medicine journals publish randomized trials addressing a wide range of clinical topics. Randomized trials focusing on geriatric patients are not commonly published in these journals.
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Randomized Controlled Trial Comparative Study
Optimal external laryngeal manipulation: modified bimanual laryngoscopy.
External laryngeal manipulation (ELM) is commonly used to facilitate laryngeal view during direct laryngoscopy. We evaluated the effectiveness of the newly modified bimanual laryngoscopy, which involves a direct guidance of an assistant's hand by a laryngoscopist, to optimize laryngeal exposure during direct laryngoscopy compared with conventional bimanual laryngoscopy. ⋯ The modified bimanual laryngoscopy is more effective for obtaining the optimal laryngeal view on the first attempt compared with the conventional bimanual laryngoscopy.
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Randomized Controlled Trial
Decision support system in prehospital care: a randomized controlled simulation study.
Prehospital emergency medicine is a challenging discipline characterized by a high level of acuity, a lack of clinical information and a wide range of clinical conditions. These factors contribute to the fact that prehospital emergency medicine is a high-risk discipline in terms of medical errors. Prehospital use of Computerized Decision Support System (CDSS) may be a way to increase patient safety but very few studies evaluate the effect in prehospital care. The aim of the present study is to evaluate a CDSS. ⋯ The results indicate that this CDSS increases the ambulance nurses' compliance with regional prehospital guidelines but at the expense of an increase in OST.
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Multicenter Study
Emergency airway management in geriatric and younger patients: analysis of a multicenter prospective observational study.
There is little information on geriatric emergency airway management. We sought to describe intubation practices and outcomes for emergency department (ED) geriatric and younger patients in Japan. ⋯ In our multicenter study involving a large geriatric population, we found that geriatric patients were intubated with a higher success rate, compared to younger patients. These data provide implications for the geriatric ED airway practice that may lead to better patient-centered emergency care.