European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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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Acute urinary retention (AUR) is a common presentation to emergency departments. This article updates the reader on the appropriate management, investigations and guidelines for AUR. ⋯ It outlines urethral catheterization techniques for difficult cases, reviews suprapubic catheterization procedures and describes the management of AUR in polytrauma. Although emergency management is by bladder drainage, key points in the history and examination may expose significant, latent pathologies.
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Randomized Controlled Trial Comparative Study
Comparison of the Airtraq laryngoscope versus the conventional Macintosh laryngoscope while wearing CBRN-PPE.
The rapid management of respiratory failure after exposure to a CBRN agent (chemical, biological, radiological and nuclear) is a priority leading to a decrease in mortality. We studied the performance of orotracheal intubation (OTI) with the Airtraq laryngoscope compared with the Macintosh laryngoscope by emergency physicians in protective CBRN type III personal protective equipment. ⋯ This study on manikins shows that the Macintosh laryngoscope is superior to the Airtraq laryngoscope in terms of OTI speed, efficiency, and overall ease of use. The Macintosh device is one of the alternatives in the OTI of normal airways by emergency doctors in CBRN personal protective equipment clothing.
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Comparative Study Observational Study
Point-of-care troponinT is inferior to high-sensitivity troponinT for ruling out acute myocardial infarction in the emergency department.
Point-of-care testing (POCT) cardiac troponin (cTn) measurements are being used increasingly, despite the fact that evidence on the safety of their use is outdated, not taking into account current 'gold standard' high-sensitivity cardiac troponin (hs-cTn) assays. In the present study, we aimed to compare the analytical and diagnostic performance of the AQT90-flex POCT cTnT assay (which is the POCT assay with the lowest reported 99th percentile cutoff currently available) with the laboratory-based Roche Modular E170 hs-cTnT assay. ⋯ The AQT90-flex POCT cTnT assay is not yet sensitive and reliable enough to be used to exclude AMI in the ED with a single blood draw at the time of presentation in the ED, and therefore, may have limited applicability in the ED setting.