Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objectives were to determine the effect of pediatric airway management training on paramedic self-efficacy and skill performance and to determine which of several retraining methods is superior. ⋯ Training provides increases in self-efficacy, particularly among paramedics from low-call-volume areas. A gap exists between self-efficacy and skill performance, in that self-efficacy may be maintained even when skill performance declines. Pediatric airway skills decay quickly, ETI skills drop off more significantly than BMV skills, and a lecture and demonstration format seems superior to other retraining methods investigated.
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Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED). The objective of this study was to examine ED workplace violence and staff perceptions of physical safety. ⋯ This study showed that violence and weapons in the ED are common, and nurses were less likely to feel safe than other ED staff.
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Little is known about recent trends in U.S. emergency department (ED) visits for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) or about ED management of AECOPD. This study aimed to describe the epidemiology of ED visits for AECOPD and to evaluate concordance with guideline-recommended care. ⋯ The high burden of ED visits for AECOPD persisted. Overall concordance with guideline-recommended care for AECOPD was moderate, and some emergency treatments had improved over time.
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The objective was to estimate emergency physician (EP) workforce needs, taking into account the diversity of U.S. emergency departments (EDs) and various projections of EP supply and demand. ⋯ Supply of EM residency-trained, board-certified EPs is not likely to meet demand in the near future. Alternative EP staffing arrangements merit further consideration.
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Comparative Study
Determining the optimal dose of intravenous fat emulsion for the treatment of severe verapamil toxicity in a rodent model.
Recent animal studies have shown that intravenous fat emulsion (IFE) increases survival and hemodynamics in severe verapamil toxicity. However, the optimal dose of IFE is unknown. The primary objective was to determine the optimal dose of IFE based on survival in severe verapamil toxicity. Secondary objectives were to determine the effects on hemodynamic and metabolic parameters. The hypothesis was that there is a dose-dependent effect of IFE on survival until a maximum dose is reached. ⋯ The greatest benefit to survival occurs with 18.6 mL/kg IFE, while the greatest benefit to HR, MAP, and BE occurs at 24.8 mL/kg IFE. The optimal dose for the treatment of severe verapamil toxicity in this murine model was 18.6 mL/kg.