Emergency medicine journal : EMJ
-
Review Comparative Study
Development of the specialty of emergency medicine in Israel: comparison with the UK and US models.
To describe the development of emergency medicine (EM) in Israel and review the specific problems faced by the discipline and describe the solutions that were found. ⋯ Development of EM can and should take different paths according to the specific local needs and realities. There is no single ideal model suitable for all circumstances. The practice of clinical EM in Israel is comparable with that of any developed country and daily progress is being made in the academic areas of teaching and research. There are worldwide similarities in the process of developing EM as a distinct discipline.
-
A short cut review was carried out to establish whether the absence of a clinical pulse deficit can be used to exclude dissecting thoracic aneurysm in patients with chest pain. Altogether 89 papers were found using the reported search, of which one was a previous systematic literature review. ⋯ The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
-
A short cut review was carried out to establish whether primary closure of animal bites increases wound infection rates. Altogether 74 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.
-
Review Case Reports
Propofol combined with lorazepam for severe poly substance misuse and withdrawal states in intensive care unit: a case series and review.
A safe, rapid, and effective way to detoxify patients from substance misuse is important in facilitating further treatment of their psychiatric or substance use disorder. This paper discusses the treatment of acute withdrawal from polysubstance misuse in three patients in the intensive care unit setting using combined sedation with a benzodiazepine, lorazepam, and a general anaesthetic, propofol. Lorazepam alone was not effective in massive doses in these cases. The advantages and mechanism of action of using multiple agents to control refractory symptoms is discussed.
-
A systematic review was undertaken to identify published evidence relating to patient satisfaction in emergency medicine. Reviewed papers were divided into those that identified the factors influencing overall satisfaction in emergency department patients, and those in which a specific intervention was evaluated. Patient age and race influenced satisfaction in some, but not all, studies. ⋯ None of the intervention studies looked specifically at the effect of reducing the perceived waiting time. Key interventions to improve patient satisfaction will be those that develop the interpersonal and attitudinal skills of staff, increase the information provided, and reduce the perceived waiting time. Future research should use a mixture of quantitative and qualitative methods to evaluate specific interventions.