European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
Influence of case-based e-learning on students' performance in point-of-care ultrasound courses: a randomized trial.
Theoretical knowledge, visual perception, and sensorimotor skills are key elements in ultrasound education. Classroom-based presentations are used routinely to teach theoretical knowledge, whereas visual perception and sensorimotor skills typically require hands-on training (HT). We aimed to compare the effect of classroom-based lectures versus a case-based e-learning (based on clinical cases only) on the hands-on performance of trainees during an emergency ultrasound course. ⋯ e-learning exclusively based on clinical cases is an effective method of education in preparation for HT sessions and can reduce attendance time in ultrasound courses.
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Many studies illustrate variation in pain management protocols in emergency medicine. This study examines analgesia frameworks in emergency departments (EDs) in multiple countries, compares them with the recent literature, and illuminates the variability in protocols and treatment. A survey was conducted assessing the pain management framework and practices in a convenience sample of 40 hospitals distributed over 22 countries. ⋯ All (100%) reported analgesia administration in the trauma room. Oral paracetamol (67.5%) and intravenous morphine (92.5%) were the most commonly used analgesics. The variability in the pain management framework is high among EDs worldwide, highlighting the need for more international uniformity in analgesia practices in the ED.
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Reverse triage is a way to rapidly create inpatient surge capacity by identifying hospitalized patients who do not require major medical assistance for at least 96 h and who only have a small risk for serious complications resulting from early discharge. Electronic searches were conducted in the MEDLINE, TRIP, Cochrane Library, CINAHL, EMBASE, Web of Science, and SCOPUS databases to identify relevant publications published from 2004 to 2014. The reference lists of all relevant articles were screened for additional relevant studies that might have been missed in the primary searches. ⋯ When time to a medical referral or bed is less than 4-6 h, 100 additional lives per annum are predicted to be potentially saved. The results of our systematic review identified only a small number of publications addressing reverse triage, indicating that reverse triage and surge capacity are relatively new subjects of research within the medical field. Not all research questions could be fully answered.
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Comparative Study Observational Study
Ultrasonographic comparison of two landmarks for the internal jugular vein: high versus conventional approach.
We assessed and compared two landmarks (conventional vs. high approach) used in internal jugular vein (IJV) cannulation with respect to the degree of overlap with the carotid artery (CA) and the cross-sectional area (CSA) of the IJV using ultrasonography. ⋯ The high approach for IJV cannulation decreased both the degree of overlap with the CA and CSA of the IJV and increased the depth of the IJV from the skin compared with the conventional approach.
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Access to patients can be restricted in emergency situations. A variety of techniques and devices are available for use in patients who require oxygenation in a restricted-access situation. ⋯ Supraglottic airway devices appear to offer advantages in restricted-access situations.