Procedural sedation in the emergency department by Italian emergency physicians: results of the SEED SIMEU registry.

Background And Importance: Effective and safe procedural sedation is pivotal for the quality of care in the emergency department (ED).

Objectives: The aim of this work is to evaluate the feasibility, effectiveness, and safety procedural sedation performed by emergency physicians in the ED setting in Italy.

Design/setting And Participants/intervention: Following a specific training of the staff and with the adoption of a standardized protocol, a registry of procedural sedations performed on adult patients in 10 Italian EDs was compiled from 2019 to 2022; the following basic data were recorded: demographic and clinical information, procedure's indication, administered drugs, predefined, and actual sedation level.

Comment on Savioli et al. Mild Head Trauma: Is Antiplatelet Therapy a Risk Factor for Hemorrhagic Complications? 2021, , 357.

We read the article of Savioli G. et al. [.

Lung Ultrasound-Implemented Diagnosis of Acute Decompensated Heart Failure in the ED: A SIMEU Multicenter Study.

Background: Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED.

Dependence of bronchoconstrictor and bronchodilator responses on thoracic gas compression volume.

Background And Objective: During forced expiration, alveolar pressure (PALV ) increases and intrathoracic gas is compressed. Thus, 1-s forced expiratory volume measured by spirometry (FEV1-sp ) is smaller than 1-s forced expiratory volume measured by plethysmography (FEV1-pl ). Thoracic gas compression volume (TGCV) depends on the amount of gas within the lung when expiratory flow limitation occurs in the airways.

Short-term variability in respiratory impedance and effect of deep breath in asthmatic and healthy subjects with airway smooth muscle activation and unloading.

Inspiratory resistance (RINSP) and reactance (XINSP) were measured for 7 min at 5 Hz in 10 subjects with mild asymptomatic asthma and 9 healthy subjects to assess the effects of airway smooth muscle (ASM) activation by methacholine (MCh) and unloading by chest wall strapping (CWS) on the variability of lung function and the effects of deep inspiration (DI). Subjects were studied at control conditions, after MCh, with CWS, and after MCh with CWS. In all experimental conditions XINSP was significantly more negative in subjects with asthma than in healthy subjects, suggesting greater inhomogeneity in the former.

Factors influencing desired and received analgesia in emergency department.

Oligoanalgesia in Emergency Departments (ED) is known to be common. The aim of our study is to determine how often patients in pain desire and receive analgesics while in the ED. Four main outcomes have been considered: desire of analgesics, administration of analgesics in the ED, correlation between initial analgesic administration and triage priority scores, patients' satisfaction at discharge during the ED visit.

Nontraumatic headaches in the emergency department: evaluation of a clinical pathway.

Objective: To determine the impact and efficacy of a clinical pathway in the management of patients with nontraumatic and afebrile headache (NTAH) in the emergency department (ED).

Background: Nontraumatic and afebrile headache is one of the most common neurological symptoms in the ED. However, data about the application of an evidence-based operative protocol are lacking.

Multiple abscesses in brucellosis with Wright's test negativity.

We report a case of metastatic abscesses caused by a chronic form of brucellosis in a shepherd. When she was admitted the patient was cachectic with haematological signs of phlogosis. An abdominal computed tomography scan revealed the presence of multiple hepatic and renal abscesses with a fluid mass in the abdominal wall.

Mechanical response to methacholine and deep inspiration in supine men.

The effects of supine posture on airway responses to inhaled methacholine and deep inspiration (DI) were studied in seven male volunteers. On a control day, subjects were in a seated position during both methacholine inhalation and lung function measurements. On a second occasion, the whole procedure was repeated with the subjects lying supine for the entire duration of the study.