Emergency medicine journal : EMJ
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Randomized Controlled Trial Multicenter Study
Digital anaesthesia: one injection or two?
Digital nerve blocks (DNB) are performed frequently in the Emergency Department (ED). The aim of this study was to establish whether single injection subcutaneous digital nerve block (SDNB) is as effective as the traditional (two injection) digital nerve block (TDNB) for digital anaesthesia. ⋯ SDNB is as effective as TDNB. Outcome measures favoured SDNB, but only CS scores achieved statistical significance. Trial recruitment is much slower than anticipated. However, clinical practice has demonstrated that SDNB works and practice is already changing within the Hampshire region, with some departments adopting SDNB as standard practice. Therefore, the results are being presented now to allow clinicians to make an informed choice. Our results may also contribute to future metanalyses.
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Multicenter Study Comparative Study Clinical Trial
Endotracheal intubation using a GlideScope video laryngoscope by emergency physicians: a multicentre analysis of 345 attempts in adult patients.
To investigate the use and success rates of the GlideScope (GVL) by emergency physicians (EPs) during the initial two years after its introduction. ⋯ The GVL was not used frequently by EPs during the initial two years after its introduction. Although the GVL provides a better glottic view, the overall success rates were similar to a CL. The GVL may be useful in patients with difficult airway.
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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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Multicenter Study
Protocol-driven trauma resuscitation: survey of UK practice.
To evaluate the use of protocol-driven trauma resuscitation strategies in UK emergency departments. ⋯ The utilisation of trauma resuscitation protocols and guidelines in British emergency departments is limited. Given the clear benefits of these strategies, consideration should be given to greater integration of such algorithms into practice.
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Safety in prehospital practice is a paramount principle. Personal protective equipment (PPE) use is intrinsic to safe practice. There is varied guidance as to what constitutes effective PPE. No evidence is available of what current provision encompasses. ⋯ Many reasons account for the differences in provision. There is a clear need for a standard to be set nationally in conjunction with locally implemented evaluation and re-accreditation processes.