Emergency medicine journal : EMJ
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Randomized Controlled Trial
Point of care troponin decreases time in the emergency department for patients with possible acute coronary syndrome: a randomised controlled trial.
To determine the effect of cardiac troponin I testing with a point-of-care (POC) device versus central laboratory on length of stay (LOS) in emergency department (ED) patients presenting with possible acute coronary syndromes (ACS). ⋯ POC testing for troponin in the ED tended to reduce the LOS for possible ACS patients. The degree of this benefit is likely to be markedly dependent on its acceptance and uptake by attending personnel, and on the ED setting in which it is used.
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Randomized Controlled Trial Multicenter Study
Clinical diagnosis of acute coronary syndrome in patients with chest pain and a normal or non-diagnostic electrocardiogram.
Clinical features may be used to determine which patients with suspected acute coronary syndrome (ACS), but a normal or non-diagnostic ECG, should be selected for further investigation or inpatient care. We aimed to measure the diagnostic value of clinical features for ACS. ⋯ Clinical features have very limited value for diagnosing ACS in patients with a normal or non-diagnostic ECG. Radiation of pain to the right arm increases the likelihood of ACS.
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Randomized Controlled Trial
Effects of bed height on the performance of chest compressions.
The correct chest compression technique was emphasised to enhance the result of cardiopulmonary resuscitation in the 2005 guidelines. The present study compared the effects of different bed heights, including a bed at knee height, on the performance of chest compressions. ⋯ The performance of chest compressions decreased when the bed height was 20 cm higher than the knee height of the rescuer.
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Randomized Controlled Trial
Role of surgeon-performed ultrasound on further management of patients with acute abdominal pain: a randomised controlled clinical trial.
The use of bedside ultrasound performed by the surgeon or emergency physician on duty at the emergency department is increasing. A study was performed which is the first randomised study to evaluate the benefits of surgeon-performed ultrasound for the management of the acute abdomen. ⋯ This study shows benefits in the management of the acute abdomen resulting in fewer further requested examinations, fewer admissions and shorter lead times to surgery. On the basis of these results, it is recommended for implementation in emergency departments.
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Randomized Controlled Trial Comparative Study
Amethocaine versus EMLA for successful intravenous cannulation in a children's emergency department: a randomised controlled study.
Topical anaesthetics reduce the pain of venous cannulation. The emergency department at the Starship Children's Hospital in Auckland uses EMLA (an eutectic mixture of 25 mg/g lidocaine and 25 mg/g prilocaine) for topical anaesthesia. Amethocaine has recently been shown to be a more effective topical anaesthetic. It is suggested that, because amethocaine does not vasoconstrict veins, it may increase the success of cannulation. ⋯ Amethocaine is not more successful than EMLA for first attempt intravenous cannulation in a children's emergency department.