International journal of emergency medicine
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Electrolyte values are measured both by arterial blood gas (ABG) analyzers and central laboratory auto-analyzers (AA), but a significant time gap exists between the availability of both these results, with the ABG giving faster results than the AA. The authors hypothesized that there is no difference between the results obtained after measurement of electrolytes by the blood gas and auto-analyzers. ⋯ Based on the above analysis, the authors found no significant difference between the potassium values measured by the blood gas machine and the auto-analyzer. However, the difference between the measured sodium was found to be significant. We therefore conclude that critical decisions can be made by trusting the potassium values obtained from the arterial blood gas analysis.
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Vascular access is a critical skill for emergency physicians. However, it can be unpredictably challenging in some patients. While ultrasound-guided vascular access has been encouraged in emergency departments, there have been few studies evaluating echo-enhanced needles and their usefulness in performing vascular access. ⋯ Echo-enhanced needles did not provide objective performance improvement compared to standard needles during ultrasound-guided vascular access with a vascular access model in the short axis.
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Postintubation chest X-rays (CXR) are standard practice in emergency department (ED) intubations. In the operating room, it is not usually a standard practice to confirm endotracheal tube placement with a CXR. ⋯ ED intubations were judged to have "satisfactory" placement by CXR in 81% of patients. CXR is able to identify a small subset of patients that likely need immediate intervention based on their CXR. Until further studies refute the utility of postintubation CXR in ED intubations, they should remain a part of routine practice.
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Analgesic use, particularly opioids in the emergency situation in patients with acute abdominal pain, generally has been avoided in the past; however, newer evidence has shown that the practice should be encouraged. In spite of this, many physicians still withhold analgesics in this clinical situation. ⋯ The study has shown that the dogma that analgesics are harmful in patients with acute abdominal pain is still firmly entrenched in the practice of the surveyed Nigerian doctors. This belief is not significantly affected by specialty or post-qualification experience.
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International research has demonstrated disparities in the Emergency Department care of patients of certain racial or ethnic backgrounds. The management of minor head injuries requires a careful clinical assessment to determine the requirement of a CT scan of the head. The aim of this study was to determine if there was any disparity, based on race, in the management of minor head injury. ⋯ This study concluded that there was no statistically significant disparity based upon race in the management of minor head injuries with regard to decision to perform a CT head scan. There is some evidence that indigenous patients waited longer to be seen. A multi-centre prospective study is necessary to confirm these findings.