Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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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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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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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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Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury. ⋯ In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.