Added On : 5th July 2011Ultrasound Better Than Landmark Guidance for Subclavian Vein Cannulation
In a direct comparison, ultrasound guidance was faster, more successful, and associated with fewer complications.
Ultrasound-guided procedures are becoming increasingly common in the emergency department, but do they improve outcomes? Investigators in Greece prospectively randomized 463 sedated and ventilated intensive care unit patients to undergo infraclavicular subclavian vein cannulation guided by real-time ultrasound or the landmark method; 62 patients in the landmark group were converted to the ultrasound group because of technical difficulties and were excluded.
Added On : 15th August 2011Warming reduces pain, even when the anesthetic is buffered.
Injection of local anesthetics causes pain at the injection site before providing anesthesia. Postulated methods to mitigate this pain include slowing the rate of injection; avoiding epinephrine, when possible; buffering; and warming the local anesthetic to body temperature prior to injection. These authors assessed injection pain in a meta-analysis of 18 randomized studies involving 831 patients who received either warmed (body temperature) or unwarmed (room temperature) subcutaneous or intradermal local anesthetic injections. The anesthetic was unbuffered in ten studies.
Added On : 10th October 2011Obtaining only one electrocardiogram would have missed 15% of patients with STEMI in a single prehospital system.
Prehospital detection of acute ST-segment-elevation myocardial infarction (STEMI) facilitates transport of patients directly to percutaneous coronary intervention (PCI)-capable centers, and earlier detection lowers mortality. To assess whether performance of serial electrocardiograms (ECGs) improves detection of STEMI, researchers reviewed records for 325 consecutive patients with STEMI who were transported by the Toronto emergency medical services (EMS) system during 1 year.