Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Digital versus local anesthesia for finger lacerations: a randomized controlled trial.
To compare the pain of needle insertion, anesthesia, and suturing in finger lacerations after local anesthesia with prior topical anesthesia with that experienced after digital anesthesia. ⋯ Digital and local anesthesia of finger lacerations with prior application of LET to all wounds results in similar pain of needle insertion, anesthetic infiltration, and pain of suturing.
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Paramedics, who often are the first to provide emergency care to critically ill patients, must be proficient in endotracheal intubation (ETI). Training in the controlled operating room (OR) setting is a common method for learning basic ETI technique. ⋯ Despite its key role in airway management education, the quantity and nature of OR ETI training that is available to paramedic students is limited in comparison to that available to other ETI providers.
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Effective clinical teaching in emergency departments (EDs) presents unique challenges. No validated approaches to enhancing ED teaching have been reported. The authors evaluated the effectiveness of a novel one-day evidence-based, skills-oriented faculty development course tailored to ED teachers (ED STAT!). ⋯ ED STAT! improves participants' knowledge about ED-specific teaching strategies, and this improvement is maintained at one month. Participants reported high satisfaction and a positive effect on teaching behavior.
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Clinical Trial
Length of stay by route of contrast administration for diagnosis of appendicitis by computed-tomography scan.
Studies show equivalent accuracy of abdominal computed tomography (CT) using rectal contrast compared with oral contrast for diagnosing appendicitis. The authors evaluated whether emergency department (ED) length of stay and satisfaction differed by route of contrast administration for abdominal CT. ⋯ Rectal contrast for patients undergoing abdominal CT to rule out appendicitis reduced ED length of stay by more than an hour and did not affect patient satisfaction or discomfort. Rectal-contrast administration for abdominal CT may significantly shorten patient throughput time for individuals undergoing evaluation for appendicitis.
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The findings are presented of a consensus group created to address the standardization of performance measures for emergency medicine. This group, whose members have affiliations with most major organizations interested in emergency medicine performance, benchmarking and quality improvement, was tasked with standardizing definitions pertinent to emergency department performance measures, creating a set of general and operational measures, developing a comparison system for benchmarking and creating a plan for the dissemination of this information. The formation of this group, the problem statement, and the mission statement for the summit are all described, and the consensus document is presented.