European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
A comparison of the i-gel and classic LMA insertion in manikins by experienced and novice physicians.
Airway management is of utmost importance in critical patients, for whom endotracheal intubation remains the gold standard. However, it is a difficult skill to acquire and success rates in novices are unacceptably low. Supraglottic devices constitute promising alternatives. The aim of this study was to assess the use of laryngeal mask airway (LMA) classic LMA (cLMA) and a relatively new supraglottic device, the i-gel, in experienced and novice doctors in a manikin setting. ⋯ In this manikin setting i-gel significantly improved success rates and insertion time compared with cLMA. Most importantly, i-gel use resulted in high first pass success rates for novice doctors, equal to those achieved by experienced doctors.
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In this study, we aimed to compare serum creatinine, blood urea, and glomerular filtration rate (GFR) levels of patients at baseline and 48 h after the administration of radiocontrast agent in the emergency department. ⋯ There was no statistically significant difference between basal and 48 h after the administration of radiocontrast agent serum creatinine and GFR levels of patients who were enrolled in this study. Results had shown that administration of intravenous radiocontrast agent (≤100 ml) for emergency imaging in the emergency department did not produce a risk for contrast-induced nephropathy in patients with serum creatinine levels of 1.5 mg/dl or less.
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The objective of this study was to evaluate the supplemental oxygen use in hospital emergency departments (EDs) in Victoria. A prospective exploratory design was used. All patients attending the three-study EDs during the data-collection periods and who could give informed consent were eligible for inclusion. ⋯ Patients who received oxygen were older (P<0.001), had higher incidence of ambulance transport to ED (P<0.001) and hospital admission (P<0.001) and higher median respiratory (P<0.001) and median heart rates (P=0.008). Oxygen is a major component of emergency care. Patients who received oxygen were more likely to have clear evidence of physiological abnormalities; however, oxygen decision-making warrants more detailed investigation.
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Spinal epidural hematoma (SEH) is a rare neurosurgical emergency. SEH is characterized by an archetypal clinical presentation including abrupt spinal pain followed more or less rapidly by various degrees of neurological deficit. The diagnosis of SEH, often based on a clinical presumption, represents a clinical challenge. ⋯ We suggest that SEH is a dynamic disease, which occurs in patients with an abnormal vasculature structural degenerative change. The bleeding is probably of multifactorial origin incriminating veins as well as arteries. Therefore, we proposed a classification of SEH, according to the most probable etiology whatever the associated factors, in six groups: spontaneous, secondary, iatrogenic, traumatic, recurrent, and idiopathic SEH.