European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
e-Learning versus lecture-based courses in ECG interpretation for undergraduate medical students: a randomized noninferiority study.
An ECG is pivotal for the diagnosis of coronary heart disease. Previous studies have reported deficiencies in ECG interpretation skills that have been responsible for misdiagnosis. However, the optimal way to acquire ECG interpretation skills is still under discussion. Thus, our objective was to compare the effectiveness of e-learning and lecture-based courses for learning ECG interpretation skills in a large randomized study. ⋯ Our randomized study showed that the e-learning course is an effective tool for the acquisition of ECG interpretation skills by medical students. These preliminary results should be confirmed with further multicenter studies before the implementation of e-learning courses for learning ECG interpretation skills during medical school.
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Randomized Controlled Trial Comparative Study
Comparison of two intraosseous devices in adult patients in the emergency setting: a pilot study.
To compare two intraosseous (IO) insertion devices in terms of safety and ease of use in patients who need urgent vascular access in the emergency setting following failed attempts for intravenous lines. ⋯ Both EZ-IO and BIG are shown to be reliable and safe methods for insertion of intravascular access in emergency conditions.
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To determine the effect of blood sampling through an intravenous catheter compared with a needle in Emergency Department blood sampling. ⋯ Blood sampling via an intravenous catheter was significantly associated with an increase in the likelihood of sample haemolysis compared with sampling with a needle. Wherever practicable, blood samples should be obtained via a needle in preference to an intravenous catheter. Future research should include both an economic evaluation, and staff and patient satisfaction of separating blood sampling and intravenous catheter placement.
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In previous studies including patients with suspected cardiac chest pain, those who had acute myocardial infarction (AMI) reported more severe chest pain than those without AMI. However, many patients with AMI present with very mild pain or discomfort. We aimed to investigate whether peak pain severity, as reported by patients in the Emergency Department, has any potential role in the risk stratification of patients with suspected cardiac chest pain. ⋯ Pain score has limited diagnostic value for AMI. Scores should guide analgesia but shift the probability of AMI very little, and should not guide other clinical management.