Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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One of the first stages in the development of new clinical decision rules (CDRs) is determination of need. This study examined the clinical priorities of emergency physicians (EPs) working in Australasia, Canada, the United Kingdom, and the United States for the development of future CDRs. ⋯ This international survey identified the sampled EPs' priorities for the future development of CDRs. The top priority overall was investigation of the febrile child < 36 months. These results will be valuable to researchers for future development of CDRs in EM that are relevant internationally.
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To explore the prevalence of substance use among emergency medicine (EM) residents and compare to a prior study conducted in 1992. ⋯ Self-reported use of most street drugs remains uncommon among EM residents. Marijuana and alcohol use, however, do appear to be increasing. Educators should be aware of these trends, and this may allow them to target resources for impaired and at-risk residents.
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Review Comparative Study
Safety and clinical effectiveness of midazolam versus propofol for procedural sedation in the emergency department: a systematic review.
To synthesize the evidence comparing the adverse event (AE) profile and clinical effectiveness of midazolam and propofol for procedural sedation (PS) in adults in the emergency care setting. ⋯ The authors found no significant difference in the safety profile and the proportion of successful PS between midazolam and propofol for adults in the ED.
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Emergency medicine research requires the enrollment of subjects with varying decision-making capacities, including capable adults, adults incapacitated by illness or injury, and children. These different categories of subjects are protected by multiple federal regulations. These include the federal Common Rule, the Department of Health and Human Services (DHHS) regulations for pediatric research, and the Food and Drug Administration's (FDA) Final Rule for the Exception from the Requirements of Informed Consent in Emergency Situations. ⋯ This article is intended as a guide for emergency researchers and IRB members who review emergency research. It reviews the elements of Federal Regulations that apply to consent, subject selection, privacy protection, and the analysis of risks and benefits in all emergency research. It explores the challenges for IRB review listed above, and offers potential solutions to these problems.