Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Ultrasonographic investigation of the effect of inguinal compression on the cross-sectional area of the femoral vein.
The reverse Trendelenburg position increases the cross-sectional area (CSA) of the femoral vein, making it easier to cannulate, although this position is potentially harmful in hypovolemic patients. The authors hypothesized that compression above the femoral vein increases the CSA of the femoral vein during emergency cannulation. ⋯ Inguinal compression presents an alternative method for increasing the CSA of the femoral vein for venous catheterization in normal patients.
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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.
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Comparative Study
A cost-effectiveness analysis of propofol versus midazolam for procedural sedation in the emergency department.
To determine the incremental cost-effectiveness of using propofol versus midazolam for procedural sedation (PS) in adults in the emergency department (ED). ⋯ These results indicate that using propofol for PS in the ED is a cost-saving strategy.
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Depression is the most common psychiatric disorder among adolescents and is more prevalent among those seeking care in the emergency department (ED). However, adolescents are rarely screened for depressive symptoms in the pediatric emergency department (PED). ⋯ The two-question screen is a sensitive and specific initial screen for depressive symptoms in adolescents being seen in the PED. This quick, simple instrument would be ideal for use in the busy PED setting and would allow clinicians to identify adolescents who require more extensive psychiatric evaluation.
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To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use. ⋯ Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine-related ED visits are most commonly related to mental illness, trauma, skin, and dental-related problems.