Emergency medicine journal : EMJ
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To determine the difference between rocuronium and succinylcholine with regard to post-intubation sedative initiation in the emergency department. ⋯ Patients intubated with rocuronium had greater delays in post-intubation sedative initiation compared with succinylcholine.
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The National Health Service (NHS) depends on a highly skilled workforce. Anything threatening the well-being of that workforce threatens the delivery of healthcare. Violence and aggression directed towards healthcare professionals is a longstanding problem within the NHS, and is particularly acute in the Emergency Department (ED). This study examined ED staff perceptions and experiences of violent behaviour directed towards them within the ED. ⋯ This study adds to current evidence regarding how staff perceive and experience violence in the ED. Given the variation in reporting behaviour, national figures on violence within the NHS are likely to be underestimated. More research is needed to understand the true prevalence of violence occurring in the ED.
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Emergency care services face common challenges worldwide, including the failure to identify emergency illnesses, deviations from standard treatments, deterioration in the quality of medical care, increased costs from unnecessary testing, and insufficient education and training of emergency personnel. These issues are currently being addressed by implementing emergency department information systems (EDIS) and clinical decision support systems (CDSS). ⋯ In addition, language barriers make it difficult to introduce EDIS and CDSS in Japan that have been created for an English-speaking market. This perspective addresses the key events that motivated a campaign to prioritise these services in Japan and the need to customise EDIS and CDSS for its population.
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Therapeutic hypothermia has become the standard treatment for unconscious patients in cardiac arrest. Although various body parts, including the oesophagus, rectum, bladder and tympanum, can be used for measurement of the core temperature, the oesophageal temperature is preferred because of its accuracy and stability. We first investigated the success rate and procedure time of oesophageal temperature probe (ETP) insertion according to the insertion method. ⋯ The new ETP insertion method had a better first attempt success rate than the conventional method and the alternative method.
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Raised blood pressure (and heart rate (HR)) due to anxiety in a clinical situation is well described and is called the white coat effect (WCE). It is not known whether the pain and anxiety that results from trauma causes a measurable WCE. ⋯ Median HR remained approximately 10 bpm higher in the TARN (injury) set compared to the HSE (non-injury, control) set, irrespective of age. Understanding that HR reacts in this way for mild to moderately injured patients is important as it will affect clinical interpretation during the initial assessment.