Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To obtain a detailed description of the injury scene in an attempt to identify methods for prevention and to describe the morbidity and mortality of children who present to an urban pediatric emergency department (ED) with an injury caused by a falling television. ⋯ Children may present to the ED with injuries caused by falling televisions. These injuries are usually not severe; however, the potential for severe injury exists, and some children may require ICU monitoring. Our data indicate a lack of parental awareness and an absence of primary prevention as a root cause for this problem. Thus, more aggressive education to warn parents about the risk of injury must be implemented so that more families will take the time to place their televisions safely.
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Emergency medicine (EM) postgraduate training programs must prepare residents for the ethical challenges of clinical practice. Bioethics curricula have been developed for EM residents, but they are based on expert opinion rather than resident learning needs. Educational interventions based on identified learning needs are more effective at changing practice than interventions that are not. The goal of this study was to identify the bioethics learning needs of Canadian EM residents. ⋯ This needs assessment provides valuable information about the ethical challenges EM residents encounter and the ethical issues they believe they have not been prepared to face. This information should be used to direct and shape ethics education interventions for EM residents.
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Randomized Controlled Trial Comparative Study
Age effect on efficacy and side effects of two sedation and analgesia protocols on patients going through cardioversion: a randomized clinical trial.
Cardioversion (CV), a painful procedure, requires sedation and analgesia. Although several sedation agents currently are in use for CV, data on age-specific efficacy and side effects of midazolam and propofol have been limited. ⋯ Propofol appears to be a better choice for CV sedation in elders because of its short recovery time, fewer side effects, and its more comfortable sedative effect.
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The value of ventilation monitoring with end-tidal carbon dioxide (ETCO2) to anticipate acute respiratory events during emergency department (ED) procedural sedation and analgesia (PSA) is unclear. The authors sought to determine if ETCO2 monitoring would reveal findings indicating an acute respiratory event earlier than indicated by current monitoring practices. ⋯ Abnormal ETCO2 findings were observed with many acute respiratory events. A majority of patients with acute respiratory events had ETCO2 abnormalities that occurred before oxygen desaturation or observed hypoventilation.