Based on the present data, adding haloperidol plus midazolam to morphine for pain management improved pain scores and lowered morphine consumption among opium-dependent patients.

To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

It seems that emergency medicine rotation improves the medical interns' knowledge in the field of emergency medicine; and their sex, passed medical blocks and the duration of internship do not affect this knowledge.

Background:In order to assessment of intravascular fluid measurement of central venous pressure (CVP) is used via central venous catheterization (CVC). This procedure is highly invasive and may cause serious complications such as pneumothorax, infection, hematoma and etc. It is so valuable procedure if we can uses a less invasive or noninvasive procedure to assess patients intravascular fluid in critical positions.Objectives:In this study, the ultrasound was used to measure the central venous pressure (CVP).Patients and Methods:In this study, patients with Central venous catheterization were selected using simple random sampling. The largest diameter of longitudinal, transverse views and the cross-section of inferior vena cava (IVC) and internal jugular vein (IJV) were measured using the ultrasound in the bedside of the patients. Central venous pressure was measured using routine methods. Correlations between variables were analyzed using SPSS and linear regression.Results:Twenty patients with the mean age of 60.3 were studied. The main reason for cardiac catheterization was shock. There are no relationship between anterior posterior diameter of inferior vena cava and CVP of patients (P = 0.257). The longest diameter of IVC in ultrasonographic transverse view had significant association with CVP of patients (P = 0.045) but in patients with BMI > 25 it was not significant. Cross section of internal jugular vein had significant association with CVP of patients (P = 0.003). Longitudinal diameter of internal jugular vein had no significant association with CVP of patients (P = 0.052), but transverse diameter of internal jugular generally had significant association with CVP of patients (P = 0.003). Cross section of internal jugular had significant association with CVP (P = 0.001).Conclusions:Noninvasive assessment of the patient hydration condition using the ultrasound is a simple and practicable measure in emergency. With regard to the considerations, it is possible to estimate CVP via diameter measurement and cross-section of the central veins.

FIGURE 1. Computed tomography showed increased attenuation in the ambient cistern (black arrow) and cortical sulci (white arrow).

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Introduction This study assessed the impact of various one-day workshops and the work experience of advanced emergency medical technicians (AEMTs) on their prediction of patient disposition. Methods We conducted a prospective study on 267 patient transport missions to the emergency department. During the study, convenience sampling was used in all the clinical shifts of the lead author. The AEMTs completed the questionnaires, which comprised of the number of successfully completed workshops; other training courses; work experience and their perception of the patient’s disposition. The latter was compared to the ultimate disposition of patients determined by emergency medicine specialists. Results The respective figures for sensitivity, specificity, positive predictive value and negative predictive value were 86%, 80%, 33% and 66% on predicting patient disposition for AEMTs who passed fewer workshops; and 79%, 76%, 34% and 96% for the participants with less than 4 years’ work experience. The Kappa coefficient for the agreement between AEMTs’ prediction and ultimate patient disposition was 0.387. Conclusion The number of triage courses was not positively effective in the prediction of patient disposition by AEMTs; the number of years of work experience did not make a difference either. The AEMTs were fair in their prediction of patient disposition in comparison with the emergency medicine specialists.

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