International journal of emergency medicine
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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.
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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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Hypocalcemia with stridor is a well-known condition in the pediatric age group but has rarely been reported in the elderly. We report an elderly patient who presented with dyspnea and laryngeal stridor attack caused by hypocalcemia. ⋯ The cause of stridor was hypocalcemia secondary to thyroidectomy. Complete resolution of stridor was achieved by calcium replacement therapy.
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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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The Sultanate of Oman has a relatively young national health care system that could demonstrate its high performance at an international level. Emergency medicine as a specialty has developed rapidly in the country over the last decade. This has involved the parallel development of local emergency residency training, prehospital emergency care, and emergency nursing programs. ⋯ It also describes aspects of undergraduate, postgraduate, and continuous emergency medicine education in the country. Further, a glimpse into academic emergency medicine and emergency nursing is provided. Since it describes a developing specialty, the article also attempts to address briefly major future challenges and their importance to the future development of the specialty in Oman.