Cervical spine movements during laryngoscopy and orotracheal intubation: a systematic review and meta-analysis
Conclusions
Compared with the MAC, alternative devices caused less movement during laryngoscopy (C0–C4) and intubation (C0–C3). Due to the high risk of bias and the very low grade of evidence of the studies, further research is necessary to clarify the benefit of each device and to determine the efficacy of cervical immobilisation during airway management. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Correa, J. B. B., Felice, V. B., Sbruzzi, G., Friedman, G. Tags: Systematic review Source Type: research
Effect of inclined positioning on first-pass success during endotracheal intubation: a systematic review and meta-analysis
Conclusions
This systematic review and meta-analysis found no evidence of benefit or harm with inclined versus supine patient positioning during endotracheal intubation in any setting. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Turner, J. S., Hunter, B. R., Haseltine, I. D., Motzkus, C. A., DeLuna, H. M., Cooper, D. D., Ellender, T. J., Sarmiento, E. J., Menard, L. M., Kirschner, J. M. Tags: Systematic review Source Type: research
Development of a paediatric airway management checklist for the emergency department: a modified Delphi approach
Conclusions
Using the modified Delphi method, consensus was established among airway management experts around essential components for an airway management checklist intended for paediatric tracheal intubation in the ED. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Miller, K. A., Prieto, M. M., Wing, R., Goldman, M. P., Polikoff, L. A., Nishisaki, A., Nagler, J. Tags: Original research Source Type: research
Ratio of optic nerve sheath diameter to eyeball transverse diameter in cardiac arrest survivors
Optic nerve sheath diameter (ONSD) is associated with poor neurological outcomes following resuscitation.1 2 However, the cut-off values of ONSD vary and are similar to those of normal adults.2 3 The ratio of ONSD to eyeball transverse diameter (ETD) would be a better indicator for intracranial hypertension.4 However, the performance of the ONSD/ETD ratio in cardiac arrest survivors has not been studied. We conducted a prospective age-matched and sex-matched nested case–control study to investigate the performance of sonographic ONSD and ONSD/ETD ratio between out-of-hospital cardiac arrest (OHCA) survivors with good...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Ling, D.-A., Chen, J.-Y., Chen, Y.-C., Ko, Y.-C., Chang, C.-H., Lien, W.-C., Chang, W.-T., Huang, C.-H. Tags: Research letter Source Type: research
EasyTBSA as a method for calculating total body surface area burned: a validation study
Conclusions
The EasyTBSA application may improve the estimation of TBSA compared with existing methods. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Colson, C. D., Alberto, E. C., Milestone, Z. P., Batra, N., Salvador, T., Fooladi, H., Cleary, K., Izem, R., Burd, R. S. Tags: Original research Source Type: research
Establishing the research priorities of emergency medicine trainees, patients and carers across the UK and Ireland: the TERN Delphi study
Introduction The Trainee Emergency Research Network (TERN) was established in 2018 by the Royal College of Emergency Medicine (RCEM) to increase research engagement within emergency medicine (EM). The first studies were selected at early TERN meetings and involved over a hundred EDs across the UK and Ireland. It is important for research engagement that trainees are interested in projects they work on. Moreover, research priorities important to clinicians reflect their daily working practice, and differ between junior and senior medical staff.1 We therefore conducted a trainee-specific research prioritisation exercise. Met...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Hirst, R., Carlton, E., Reed, M. J., Trainee Emergency Research Network (TERN), Brookes, Connelly, Cottey, Elwan, Fadhlillah, Gwatkin, Lindsay, Naeem, Rahman, Reynard, Sabir, Tilbury, Umana, Oppen, Ward, Weegenaar Tags: Research letter Source Type: research
Woman with thigh pain after motor vehicle collision
Clinical Introduction A 34-year-old woman presented to the emergency department with right thigh pain and swelling after motor vehicle collision. The patient was conscious and mobile, and on physical examination, a right thigh ecchymosis with swelling and tenderness was noted (figure 1). Range of motion of the hip joints was intact. Point-of-care ultrasound (POCUS) (figure 2 and video 1) of the right hip was obtained. Question What is the most likely diagnosis? Lipoma. Greater trochanter avulsion fracture. Morel-Lavellée’s lesion. Synovial cyst. Answer C. Morel-Lavellée’s lesion Morel-Lavell&eacut...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Shih, C.-Y., Chuang, C.-C., Cheong, K. M. Tags: EMJ Image Challenge Source Type: research
Determining the top research priorities in UK prehospital critical care: a modified Delphi study
Conclusions
This modified Delphi study identified 20 research priorities where efforts should be concentrated to develop collaborative prehospital critical care research within the UK over the next 5 years. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Ramage, L., McLachlan, S., Williams, K., PreHOspital Trainee Operated research Network (PHOTON), Bell, Bird, Carley, Chan, Clutton, Cowan, Creed, Dungay, Folley, Leech, Hughes, Lang, Major, MacKenzie, Perkins, Phillipson, Plumb, Rawlinson, Taylor, Thomas, Tags: Open access Original research Source Type: research
Long-term outcomes and prognostic factors of extracorporeal cardiopulmonary resuscitation in patients older than 75 years: a single-centre retrospective study
Conclusion
In selected patients older than 75 years, ECPR could be beneficial by providing a shorter TCT, which may contribute to favourable neurological outcomes. Nevertheless, further studies are needed to validate these findings. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Kikuta, S., Inoue, A., Ishihara, S., Takahashi, R., Ijuin, S., Matsuyama, S., Nakayama, S. Tags: Original research Source Type: research
Association between major trauma centre care and outcomes of adult patients injured by low falls in England and Wales
Conclusion
MTC care was not associated with improved survival compared with TU/LEH care in the whole cohort. Patients who were transferred had a significant impact on the results. In patients who are not transferred, MTC care is associated with greater odds of 30-day survival in the whole cohort and in the most severely injured patients. Future research must determine the optimum means of identifying patients in need of higher-level care, the components of care which improve patient outcomes, develop patient-focused outcomes which reflect the characteristics and priorities of contemporary trauma patients, and investigate t...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Tonkins, M., Bouamra, O., Lecky, F. Tags: Original research Source Type: research
Factors associated with longer wait times, admission and reattendances in older patients attending emergency departments: an analysis of linked healthcare data
Conclusions
Age, previous attendance and attending out of hours were all associated with an increased likelihood of exceeding 4 hours in the ED, hospital admission and reattendance among patients over 75 years. These differences were less pronounced among those arriving by ambulance. Emergency call handler designation could be used to identify those at the highest risk of long ED waits, hospital admission and ED reattendance. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Maynou, L., Street, A., Burton, C., Mason, S. M., Stone, T., Martin, G., van Oppen, J., Conroy, S. Tags: Open access Original research Source Type: research
Emergency physician gender is associated with early pregnancy loss management: a multisite retrospective cohort study
Conclusion
Patients seen by female emergency physicians had higher rates of obstetrical consultation and initial operative management compared with those seen by male emergency physicians, but outcomes were similar. Additional research is required to determine why these gender differences exist and how these discrepancies may impact the care of early pregnancy loss patients. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Srajer, A., Wylie, M., Zaver, F., Lonergan, K., Brain, P., Lang, E. Tags: Editor's choice Original research Source Type: research
Gender Bias in the Emergency Department
We applaud the authors’ exploration of the topic of provider gender bias in miscarriage care in the Emergency Department (ED) in the article Emergency Physician gender influences early pregnancy loss management: a multisite retrospective cohort study.1 Unfortunately, in most settings, patients are generally dissatisfied with their miscarriage management and approximately half change providers as a result of the care they receive. As 50% of patients will change their decision based on provider recommendation, physician bias plays a critical role in practice management and ultimately patient decision-making.2 3 This is...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Ghazaryan, N., Autry, A. Tags: Commentary Source Type: research
Primary survey:Highlights from this issue
In putting together April’s Primary Survey, it struck me how wonderfully wide-ranging emergency medicine practice is. This month’s offerings include studies regarding pregnancy, trauma, airway management, and cardiac arrest; studies regarding older and paediatric patients, as well the benefits of technology. A microcosm of our professional lives. This month’s Editor’s Choice by Srajer et al examines how gender of the treating doctor may play a role in the way in which pregnancy loss is handled in the emergency department (ED). This multicentre retrospective study from Canada determined the frequency...
Source: Emergency Medicine Journal - March 20, 2023 Category: Emergency Medicine Authors: Weber, E. J. Tags: Highlights from this issue Source Type: research
'From harm to hope: the UK governments 10-year drug plan to cut crime and save lives - an emergency medicine perspective
UK drug use is increasing, and deaths due to drug misuse reached an all-time high in 2020.1 In March 2022, the UK government published its 10-year strategy to reduce drug harms. Some elements (the legal framework for drug misuse and law enforcement action) will apply to the entire UK, while health, education, housing and social care will apply only to England due to devolution of powers.2 The strategy was explicitly informed by the two-phase review of drugs by Dame Carol Black, which identified that current public provision for prevention, treatment and recovery is ‘not fit for purpose, and urgently needs repair&rsqu...
Source: Emergency Medicine Journal - February 23, 2023 Category: Emergency Medicine Authors: Humphries, C. Tags: In perspective Source Type: research
