Emergency medicine journal : EMJ
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Randomized Controlled Trial Comparative Study
A comparison of the suction laryngoscope and the Macintosh laryngoscope in emergency medical technicians: a manikin model of severe airway haemorrhage.
The use of a suction laryngoscope that enables simultaneous suction and laryngoscopy was evaluated. 34 emergency medical technicians intubated the trachea of a manikin with simulated upper airway haemorrhage using the suction laryngoscope and the Macintosh laryngoscope, in random order. When using the suction laryngoscope, the number of oesophageal intubations was lower (3/34 vs 11/34; p=0.021) and the time taken to intubation was shorter (mean (SD) 50 (15) vs 58 (27) s; p=0.041). In cases of airway haemorrhage, the use of the suction laryngoscope might be beneficial.
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Randomized Controlled Trial Comparative Study
Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department.
To compare the clinical effectiveness of intravenous paracetamol with intravenous morphine in patients with moderate to severe traumatic limb pain. ⋯ Intravenous paracetamol appears to provide a level of analgesia comparable to intravenous morphine in isolated limb trauma. Further larger studies are required.
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Emergency Care Practitioners (ECPs) are operational in the UK in a variety of emergency and urgent care settings. However, there is little evidence of the effectiveness of ECPs within these different settings. The aim of this study was to evaluate the impact of ECPs on patient pathways and care in different emergency care settings. ⋯ ECPs have a differential impact compared with usual care providers dependent on the operational service settings. Maximal impact occurs when they operate in mobile settings when care is taken to the patient. In these settings ECPs have a broader range of skills than the usual care providers (eg, paramedic), and are targeted to specific clinical groups who can benefit from alternative pathways of care (such as older people who have fallen). Trial Registration No ISRCTN22085282 (Controlled trials.com).
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Comparative Study
Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department.
The aim of this study was to evaluate the diagnostic accuracy of bedside lung ultrasound and chest radiography (CXR) in patients with suspected pneumonia compared with CT scan and final diagnosis at discharge. Design A prospective clinical study. ⋯ Bedside chest ultrasound is a reliable tool for the diagnosis of pneumonia in the ED, probably being superior to CXR in this setting. It is likely that its wider use will allow a faster diagnosis, conducive to a more appropriate and timely therapy.