Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
The consent and prescription compliance (COPRECO) study: does obtaining consent in the emergency department affect study results in a telephone follow-up study of medication compliance?
The objectives were to determine whether mandated research requirements for consent in the emergency department (ED) falsely distorts the results of a survey of patient-reported compliance with ED prescriptions and, in addition, to ascertain the level of patient compliance to medication instructions and find out the degree of displeasure expressed by patients called without prior consent. ⋯ Medicine noncompliance is a significant issue for patients discharged from the ED in this study. Although there was a trend toward greater compliance in patients who consented to the follow-up call, this did not reach statistical significance. ED patients do not object to receiving telephone follow-up for a research survey without giving prior consent.
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Multicenter Study
Prospective multicenter bronchiolitis study: predicting intensive care unit admissions.
The authors sought to identify predictors of intensive care unit (ICU) admission among children hospitalized with bronchiolitis for > or =24 hours. ⋯ In this prospective multicenter ED-based study of children admitted for bronchiolitis, four independent predictors of ICU admission were identified. The authors did not confirm many putative risk factors, but cannot rule out modest associations.
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Randomized Controlled Trial Comparative Study
Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial.
The authors sought to compare the safety and efficacy of subdissociative-dose ketamine versus fentanyl as adjunct analgesics for emergency department (ED) procedural sedation and analgesia (PSA) with propofol. ⋯ Subdissociative-dose ketamine is safer than fentanyl for ED PSA with propofol and appears to have similar efficacy.
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A systemic inflammatory response has been reported following resuscitation from cardiac arrest. The purpose of this study was to compare the magnitude of the tumor necrosis factor-alpha (TNF-alpha) response in two different swine models of ventricular fibrillation (VF) arrest. ⋯ This study demonstrates that TNF-alpha concentrations increase after resuscitation from cardiac arrest and that the TNF-alpha response is more profound in animals subjected to ischemic, spontaneous VF. The observed differences may be due to a longer resuscitation time and persistent postresuscitation hypoperfusion in the ischemic VF group. These differences need to be considered in studies evaluating mechanisms of postresuscitation organ dysfunction and defining mortality markers.
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Randomized Controlled Trial Comparative Study
Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.
Web-based learning has several potential advantages over lectures, such as anytime-anywhere access, rich multimedia, and nonlinear navigation. While known to be an effective method for learning facts, few studies have examined the effectiveness of Web-based formats for learning procedural skills. The authors sought to determine whether a Web-based tutorial is at least as effective as a didactic lecture for learning ultrasound-guided vascular access (UGVA). ⋯ Our Web-based tutorial was at least as effective as a traditional didactic lecture for teaching the knowledge and skills essential for UGVA. Participants expressed high satisfaction with this teaching technology. Web-based teaching may be a useful alternative to didactic teaching for learning procedural skills.