Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Historical Article
The influence of critical care medicine on the development of the specialty of emergency medicine: a historical perspective.
Through their largely concurrent development, the specialties of emergency medicine and critical care medicine have exerted a great deal of influence on each other. In this article, the authors trace the commonalities that emergency medicine and critical care medicine have shared and report on the historical relationship between the two specialties. As issues between emergency medicine and critical care medicine continue to emerge, the authors hope to inform the current discussion by bringing to light the controversies and questions that have been debated in the past.
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To assess emergency physician reporting patterns in Oregon before and after the passage of a mandatory intoxicated driving reporting law. ⋯ Although 44% of responding emergency physicians in Oregon were unaware of a mandated reporting law for intoxicated drivers presenting to the ED, most physicians stated an increase in their reporting practice.
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Acute decompensated heart failure (adHF) is the cause of approximately 1 million annual hospital admissions. In some of these, the use of a short-stay emergency department observation unit (EDOU) decreases 90-day ED revisits and 90-day rehospitalizations and, if subsequent hospitalization is required, results in shorter stays. ⋯ These results demonstrate that a BUN level >30 mg/dL is associated with an increased likelihood of admission in patients with adHF. This provides the emergency physician with a practical prognostic tool for disposition planning in congestive heart failure patients.
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Randomized Controlled Trial Comparative Study
Human patient simulation is effective for teaching paramedic students endotracheal intubation.
The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR). ⋯ When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI.
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Randomized Controlled Trial
Laser-assisted anesthesia prior to intravenous cannulation in volunteers: a randomized, controlled trial.
Intravenous cannulation is common and painful. Absorption of topical anesthetics is limited by the stratum corneum, the outermost layer of the epidermis. A single pulse of an erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation can remove an area of the stratum corneum, leading to enhanced uptake of topical agents, such as lidocaine, while leaving the rest of the epidermis intact. ⋯ Pretreatment of the skin with a laser device followed by a 5-minute topical lidocaine application reduces the pain of IV cannulation in volunteers.