Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
The self-inflating bulb as an airway adjunct: is it reliable in children weighing less than 20 kilograms?
To confirm the ability of the self-inflating bulb to indicate endotracheal tube (ETT) position in children weighing less than 20 kilograms, and to determine whether the presence of air in the stomach affects the bulb's accuracy. ⋯ The self-inflating bulb is a reliable method of detecting endotracheal tube position in children weighing less than 20 kg, even with the use of uncuffed endotracheal tubes. Furthermore, the presence of air in the stomach, simulating field conditions, does not affect bulb effectiveness in detecting endotracheal tube position.
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Patients with altered level of consciousness may be suffering from elevated intracranial pressure (EICP) from a variety of causes. A rapid, portable, and noninvasive means of detecting EICP is desirable when conventional imaging methods are unavailable. ⋯ Despite small numbers and selection bias, this study suggests that bedside ED US may be useful in the diagnosis of EICP.
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Comparative Study
Underdosing of midazolam in emergency endotracheal intubation.
To determine whether midazolam, when used as an induction agent for emergency department (ED) rapid-sequence intubation (RSI), is used in adequate and recommended induction doses (0.1 to 0.3 mg/kg), and to compare the accuracy of the dosing of midazolam for ED RSI with the accuracy of dosing of other agents. ⋯ Underdosing of midazolam during ED RSI is frequent, and appears to be related to incorrect dosage selection, rather than to a deliberate intention to reduce the dose used.
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To assess public views on emergency exception to informed consent in resuscitation research, public awareness of such studies, and effective methods of community consultation and public notification. ⋯ Most respondents disagreed with foregoing prospective informed consent for research participation even in emergency situations; however, many would be willing to participate in studies using emergency exception from informed consent. Most respondents would not attend community meetings, and would prefer to rely upon the media for information. Very few were aware of emergency exception from informed consent studies in their community. This suggests that current methods of community notification may not be effective.
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To assess the accuracy of emergency physicians and trainees in the interpretation of noncontrast helical computed tomography (NCHCT) for suspected renal colic by examining the interrater reliability between emergency department (ED) clinicians and radiologists. ⋯ Emergency clinicians are able to identify renal calculi with a high degree of accuracy but may miss important nonrenal abnormalities. Therefore, all patients without evidence of renal tract calculus on NCHCT must have early and appropriate follow-up.