Emergency medicine journal : EMJ
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The impacts of emergency work on firefighters have been well documented and summarised, but this is not the case for paramedics. This paper explores the literature regarding the impact of work stress on paramedics. ⋯ More studies are needed to characterise paramedics' behaviour at work. These studies could allow the development of targeted strategies to prevent health problems reported in paramedics.
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Randomized Controlled Trial
Intravenous paracetamol versus dexketoprofen versus morphine in acute mechanical low back pain in the emergency department: a randomised double-blind controlled trial.
The objective of this study was to determine the analgesic efficacy and safety of intravenous, single-dose paracetamol versus dexketoprofen versus morphine in patients presenting with mechanical low back pain (LBP) to the emergency department (ED). ⋯ Intravenous paracetamol, dexketoprofen and morphine are not superior to each other for the treatment of mechanical LBP in ED.
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A short cut review was carried out to establish whether testing for troponin levels is useful after discharge of an Implanted Cardioverter-Defibrillator (ICD). Many papers were found using the reported searches, none of which directly addressed the problem but some 13 presented the best evidence to answer the clinical question. ⋯ It is concluded that the number of ICD discharges must be taken into account when evaluating any troponin level rise. Overall a positive troponin assay post ICD discharge is independently associated with an increased mortality.
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Comparative Study
Comparison of resident and mid-level provider productivity in a high-acuity emergency department setting.
Mid-level providers (MLPs) are used in many emergency departments (EDs) to provide care in a low-acuity, high-volume setting, and are able to see more patients and generate more relative value units (RVUs) than residents in this setting. It is unknown if MLPs are as productive as emergency medicine residents in a high-acuity setting. ⋯ In a high-acuity area of the ED, MLPs see more patients per hour than residents, but generate fewer RVUs per patient. This suggests that residents may document more thoroughly than MLPs. Alternatively, MLPs may elect to see less sick patients even when working in a high-acuity area.