The American journal of emergency medicine
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Review
A scoping review of qualitative studies on pre-hospital analgesia administration and practice.
Pain is an exceedingly common complaint in the pre-hospital setting. Despite advancements in organizational protocols and guidelines, many emergency medical services (EMS) systems still fail to provide optimal pain management. This scoping review thus aimed to map the body of qualitative literature pertaining to factors influencing pre-hospital analgesia administration and practice in order to clarify concepts and understanding as well as to identify any knowledge gaps. ⋯ The factors influencing pre-hospital analgesia administration and practice remain incompletely understood. Existing tools and practice guidelines were also inadequate. This scoping review provided an overarching perspective of the extant literature, highlighting some of the significant barriers, enablers, and areas for further research.
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Meta Analysis
Outcome of cardiopulmonary resuscitation with different ventilation modes in adults: A meta-analysis.
The optimal airway management strategy for cardiac arrest remains unclear. This study aimed to compare the effects of different initial airway interventions on improving clinical outcomes based on the 2010 cardiopulmonary resuscitation (CPR) guidelines and later. ⋯ Opening the airway is significantly associated with improved clinical outcomes, and the findings suggest that effective ETI based on mask ventilation should be implemented as early as possible once the patient has experienced cardiac arrest.
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Adult epiglottitis is a serious condition that carries with it a high rate of morbidity and even mortality due to airway occlusion. ⋯ An understanding of epiglottitis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
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Review
Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review.
The novel coronavirus of 2019 (COVID-19) has resulted in a global pandemic; COVID-19 has resulted in significant challenges in the delivery of healthcare, including emergency management of multiple diagnoses, such as stroke and ST-segment myocardial infarction (STEMI). The aim of this study was to identify the impacts of the COVID-19 pandemic on emergency department care of stroke and STEMI patients. ⋯ Our analysis, using a narrative review format, indicates that there was not a significant change in time required for key interventions for stroke and STEMI emergent management, including imaging (door-to-CT), tPA administration (door-to-needle), angiographic reperfusion (door-to-puncture), and percutaneous coronary intervention (door-to-balloon). Potential future areas of investigation include how emergency department (ED) stroke and STEMI care has adapted in response to different COVID-19 variants and stages of the pandemic, as well as identifying strategies used by EDs that were successful in providing effective emergency care in the face of the pandemic.