Emergency medicine journal : EMJ
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To further evaluate the safety profile and efficacy of intramuscular ketamine for procedural sedation during paediatric minor procedures in the emergency department and to ascertain parental satisfaction with the treatment of their children. ⋯ High levels of satisfaction among parents and staff together with the avoidance of hospital admission and improved resource management should be a sufficient incentive for hospital trusts to consider the establishment of this type of service.
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Transverse sacral fractures associated with cauda equina syndrome are uncommon lesions and often missed at the time of presentation. This case report highlights the benign presentation and the unpleasant outcome of such an injury.
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A simple algorithm has been produced to assist front line ground ambulance personnel, air ambulance crews, and immediate care doctors attending trauma patients in selecting the most appropriate mode of transport from the incident scene to hospital.
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To identify those attributes experts regard as desirable qualities in the ambulance technician, paramedic, and clinical supervisor. ⋯ There was significant agreement among the experts as to the desirable attributes of ambulance staff, many of which do not feature in existing ambulance training curriculums. The findings of this study may therefore be of value in informing future curriculum development and in providing guidance for the selection of staff for each of the occupational groups.
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The relief of pain is an essential component of prehospital care and, when required is usually administered on completion of the primary survey. For simple analgesia morphine sulphate titrated to the clinical response and preceded by an antiemetic is usually effective, for example, in the relief of pain in chest trauma or myocardial infarction. For patients with multiple injuries and for those patients requiring manipulation and splintage of fractures and for entrapments and difficult extrications ketamine is a safe and effective option, which avoids the potential decrease in blood pressure and respiratory depression that is associated with opioid analgesia. This paper reports the personal experience in the prehospital administration of ketamine by a non-anaesthetist working as an immediate care practitioner as part of a British Association for Immediate Care (BASICS) Scheme.