Emergency medicine journal : EMJ
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Observational Study
Prehospital use in emergency patients of a laryngeal mask airway by ambulance paramedics is a safe and effective alternative for endotracheal intubation.
In Dutch ambulance practice, failure or inability to intubate patients with altered oxygenation and/or ventilation leaves bag-valve mask ventilation as the only alternative, which is undesirable for patient outcome. A novel Laryngeal Mask Airway Supreme (LMA-S) device may be a suitable alternative. ⋯ Ensuring ventilation support by using LMA-S by paramedics in prehospital emergency practice is safe and effective.
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To survey the attendance of patients presenting with a head injury (HI) at a UK emergency department (ED), identifying numbers, types of service and referral routes; to survey subsequent service use and to highlight the challenges in service planning and identifying which patients may potentially benefit from follow-up/rehabilitation input. ⋯ These study findings highlight the difficulties in identifying patients who would benefit from follow-up, in particular after mild HI. Our study findings will form the basis of a long-term follow-up study.
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To assess staff knowledge of Centers for Disease Control (CDC) guidelines, attitudes and barriers towards emergency department (ED) HIV testing before and after implementing an ED rapid HIV testing programme (EDRHTP). ⋯ Overall support for ED HIV testing increased after establishment of a rapid testing programme.
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Intraosseous (IO) access is becoming increasingly accepted in adult populations as an alternative to peripheral vascular access, however there is still insufficient evidence in large patient groups supporting its use. ⋯ Intraosseous access can be used for the infusion of a wide variety life saving medications, quickly, easily with low complication rates. This highlights its valuable role as an alternative method of obtaining vascular access, vital when resuscitating the critically injured trauma patient.
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Pain is the commonest reason that patients present to an Emergency Department (ED), but is often not treated effectively. Patient controlled analgesia (PCA) is used in other hospital settings but there is little evidence to support its use in emergency patients. This study (one of two parallel trials) aimed to assess the effectiveness and cost-effectiveness of PCA in emergency patients with traumatic injuries. ⋯ Provisional results indicate that there is no statistically significant reduction in pain using PCA compared to routine care for emergency department patients with traumatic injuries. Further analyses are in progress, in particular, of total morphine consumption and cost-effectiveness.