Articles: emergency-medicine.
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Naloxone has enjoyed long-standing success as a safe and effective opioid antagonist and has been invaluable in defining the role of endogenous opioid pathways in the response to pathological states such as sepsis and hypovolemia. We look forward to exciting research to further elucidate these pathways and to improve outcome by modulating the patient's physiological response to these stresses.
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The establishment of pediatric emergency medicine as a subspecialty of emergency medicine has engendered the need for closer examination and development of guidelines for fellowship training. Core content and curriculum documents pertaining to fellowship training in pediatric emergency medicine for pediatric graduates have been published previously. ⋯ We believe that emergency physicians should take an active role in the creation and refinement of educational guidelines for fellowship training in pediatric emergency medicine for emergency medicine graduates. For this reason, we present a proposed core content outline in the hope that it will serve to foster this process.
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The implementation of an experienced pre-hospital care emergency physician as an on the-scene medical command officer (MCO) within the emergency medical service (EMS) is an essential prerequisite to guarantee qualified medical supervision during mass-casuality incidents (MCI). The MCO has four basic functions. ⋯ Aside from extensive personal experience in pre-hospital care, the MCO needs special training to be qualified for this position. State EMS laws provide the legal basis for the MCO within the EMS system.
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Randomized Controlled Trial Clinical Trial
The oesophageal detector device. An assessment of accuracy and ease of use by paramedics.
Accuracy, ease and speed of recognition of tracheal tube position were assessed using the oesophageal detector device in a series of 40 tests on 29 patients. A single blind method was used, with each paramedic performing a single test on each patient. The tests were randomly split between two groups consisting of those tests performed on the tracheal or oesophageal tube respectively. ⋯ Each paramedic also graded speed of recognition of position and ease of use of the device. Recognition of position was graded as instant in 37 out of 40 tests. Use of the oesophageal detector device by previously inexperienced paramedics has thus been shown to be accurate, rapid and easy to learn.