International journal of emergency medicine
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Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management includes the use of "rescue" extracorporeal lung assist and early transport by aeromedical evacuation teams. ⋯ Novel techniques in extracorporeal lung assist and in ventilatory support may help save lives even in disaster medicine.
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Disaster medicine education is an enormous challenge, but indispensable for disaster preparedness. ⋯ The curriculum offers medical disaster education in a reasonable time frame, interdisciplinary format, and multi-experiential course. It can serve as a template for basic medical student disaster education. Because of its comprehensive but flexible structure, it should also be helpful for other health-care professional student disaster education programs.
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The use and interpretation of electrocardiograms (ECGs) are widely accepted as an essential core skill in Emergency Medicine. It is imperative that emergency physicians are expert in ECG interpretation when they exit their training programme. ⋯ In this prospective cross-sectional study of Emergency Medicine residents and recently qualified emergency physicians, we found that there was improvement in the interpretation of ECGs with increased seniority. There exists, however, a low level of accuracy for many of the critical ECG diagnoses. The average score of 46.4% obtained in this study is lower than the scores obtained by other international studies from countries where Emergency Medicine is a well-established speciality.
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This study examined the safety and effectiveness of the procedural sedation analgesia (PSA) technique carried out in the emergency department (ED) of a university hospital over a period of 1 year. The research was done to compare the effectiveness and efficacy of moderate sedation of fentanyl combined with either midazolam or propofol for any brief, intense procedure in the ED setting. ⋯ This study had proven that there was no difference in adverse event occurrence between the studied drugs during PSA. Propofol can be recommended for use in PSA if the operator is well trained and familiar with the drug.
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Capnometry measures carbon dioxide in expired air and provides the clinician with a noninvasive measure of the systemic metabolism, circulation and ventilation. This study was carried out on patients with acute breathlessness to define the utility and role of capnometry in the emergency department. ⋯ This study shows that ETCO(2) can be used to predict the PaCO(2) level when the difference between the PaCO(2) and ETCO(2) is between 2 to 6 mmHg, especially in cases of pure acidosis and hypocapnia. Using ETCO(2) to predict PaCO(2) should be done with caution, especially in cases that involve pulmonary disorders and acid-base imbalance.