J Emerg Med
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Entrapped rings can be dangerous, leading to increased pressure and damage to soft tissue, nerves, and vasculature. In order to properly care for these injuries, it is important for emergency medicine clinicians to be aware of the different approaches to remove entrapped rings. ⋯ Emergency medicine clinicians need to be familiar with several different approaches to ring removal. This article summarizes the key techniques, variations on these techniques, advantages, and disadvantages for each approach.
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Randomized Controlled Trial
Effect of Coaching with Repetitive Verbal Encouragements on Dispatch-Assisted Cardiopulmonary Resuscitation: A Randomized Simulation Study.
Current guidelines emphasize the assistance of the emergency dispatcher in bystander cardiopulmonary resusitation (CPR). Its quality, however, has varied across cases. ⋯ Repetitive verbal encouragements augmented chest compression depth with less-hands off time. Continuous coaching by dispatchers can optimize lay-rescuer CPR. © 2022 Elsevier Inc.
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Observational Study
Prevalence and Categorization of Drug-Related Problems in the Emergency Department.
Drug-related problems (DRPs) are common among patients seen in the emergency department (ED), but the true incidence is not clear. ⋯ A substantial proportion of ED visits are associated in part or in total with DRPs. Adverse drug reactions and cardiovascular medications are the most common category and medication class implicated, respectively.
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The use of sedative and analgesic agents is required for procedural sedation in the emergency department (ED). Agents such as ketamine and propofol are commonly used for procedural sedation. This is likely due to clinical experience with these agents, as well as optimal pharmacologic properties when used in combination with one another. Methohexital, a barbiturate, is less frequently used due to concerns for adverse events associated with this drug class. ⋯ Methohexital is a safe and effective option for procedural sedation for musculoskeletal procedures in the ED when compared with ketamine and propofol.
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Patients with injury may be at high risk of long-term opioid use due to the specific features of injury (e.g., injury severity), as well as patient, treatment, and provider characteristics that may influence their injury-related pain management. ⋯ Across this large cohort of multiple, mostly minor, injury types, long-term opioid use was relatively uncommon, but almost all patients with chronic use post injury had preinjury opioid use. Long-term opioid use after injury may be more closely tied to preinjury chronic pain and pain management than acute care pain management.