collection
https://read.qxmd.com/read/25278139/comparison-of-therapeutic-effects-of-magnesium-sulfate-vs-dexamethasone-metoclopramide-on-alleviating-acute-migraine-headache
#21
RANDOMIZED CONTROLLED TRIAL
Ali Shahrami, Farhad Assarzadegan, Hamid Reza Hatamabadi, Morteza Asgarzadeh, Baharak Sarehbandi, Setareh Asgarzadeh
BACKGROUND: There is controversy about the efficacy of currently used treatment modalities to alleviate migraine headaches. OBJECTIVE: We aimed to evaluate and compare the effects of magnesium sulfate and combined use of dexamethasone/metoclopramide on relieving acute migraine headache. METHODS: We randomly divided 70 patients who had been referred to an emergency department, into two equal treatment groups with the two treatment plans, and analyzed pain severity at baseline using a numeric rating scale (NRS)...
January 2015: Journal of Emergency Medicine
https://read.qxmd.com/read/24439715/ambulatory-management-of-large-spontaneous-pneumothorax-with-pigtail-catheters
#22
JOURNAL ARTICLE
Fanny Voisin, Laurent Sohier, Yann Rochas, Mallorie Kerjouan, Charles Ricordel, Chantal Belleguic, Benoit Desrues, Stéphane Jouneau
STUDY OBJECTIVE: There is no consensus about the management of large spontaneous pneumothoraces. Guidelines recommend either needle aspiration or chest tube drainage and most patients are hospitalized. We assess the efficiency of ambulatory management of large spontaneous pneumothoraces with pigtail catheters. METHODS: From February 2007 to January 2011, all primary and secondary large spontaneous pneumothoraces from Lorient's hospital (France) were managed with pigtail catheters with a 1-way valve...
September 2014: Annals of Emergency Medicine
https://read.qxmd.com/read/23927959/do-corticosteroids-benefit-patients-with-sore-throat
#23
EDITORIAL
Julie L Welch, Dylan D Cooper
No abstract text is available yet for this article.
June 2014: Annals of Emergency Medicine
https://read.qxmd.com/read/25270275/lower-versus-higher-hemoglobin-threshold-for-transfusion-in-septic-shock
#24
RANDOMIZED CONTROLLED TRIAL
Lars B Holst, Nicolai Haase, Jørn Wetterslev, Jan Wernerman, Anne B Guttormsen, Sari Karlsson, Pär I Johansson, Anders Aneman, Marianne L Vang, Robert Winding, Lars Nebrich, Helle L Nibro, Bodil S Rasmussen, Johnny R M Lauridsen, Jane S Nielsen, Anders Oldner, Ville Pettilä, Maria B Cronhjort, Lasse H Andersen, Ulf G Pedersen, Nanna Reiter, Jørgen Wiis, Jonathan O White, Lene Russell, Klaus J Thornberg, Peter B Hjortrup, Rasmus G Müller, Morten H Møller, Morten Steensen, Inga Tjäder, Kristina Kilsand, Suzanne Odeberg-Wernerman, Brit Sjøbø, Helle Bundgaard, Maria A Thyø, David Lodahl, Rikke Mærkedahl, Carsten Albeck, Dorte Illum, Mary Kruse, Per Winkel, Anders Perner
BACKGROUND: Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. METHODS: In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay...
October 9, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25272316/goal-directed-resuscitation-for-patients-with-early-septic-shock
#25
RANDOMIZED CONTROLLED TRIAL
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo, Peter A Cameron, D James Cooper, Alisa M Higgins, Anna Holdgate, Belinda D Howe, Steven A R Webb, Patricia Williams
BACKGROUND: Early goal-directed therapy (EGDT) has been endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease mortality among patients presenting to the emergency department with septic shock. However, its effectiveness is uncertain. METHODS: In this trial conducted at 51 centers (mostly in Australia or New Zealand), we randomly assigned patients presenting to the emergency department with early septic shock to receive either EGDT or usual care...
October 16, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25039544/comparison-of-short-term-infusion-regimens-of-n-acetylcysteine-plus-intravenous-fluids-sodium-bicarbonate-plus-intravenous-fluids-and-intravenous-fluids-alone-for-prevention-of-contrast-induced-nephropathy-in-the-emergency-department
#26
RANDOMIZED CONTROLLED TRIAL
Ahmet Kama, Serkan Yılmaz, Elif Yaka, Erkan Dervişoğlu, Nurettin Özgür Doğan, Emre Erimşah, Murat Pekdemir
BACKGROUND: There is no evidence regarding the several short-term prophylaxis protocols for contrast-induced nephropathy (CIN) that may be most feasibly convenient in emergency settings. OBJECTIVES: The purpose of this study was to compare the efficacies of short-term CIN prophylaxis protocols of normal saline, N-acetylcysteine (NAC) plus saline, and sodium bicarbonate plus saline in emergency department (ED) patients at moderate or high risk of CIN after receiving intravenous (IV) contrast agent...
June 2014: Academic Emergency Medicine
https://read.qxmd.com/read/24902657/the-impact-of-introducing-a-no-oral-contrast-abdominopelvic-ct-examination-nocape-pathway-on-radiology-turn-around-times-emergency-department-length-of-stay-and-patient-safety
#27
COMPARATIVE STUDY
Seyed Amirhossein Razavi, Jamlik-Omari Johnson, Michael T Kassin, Kimberly E Applegate
This investigation evaluates the impact of the no oral contrast abdominopelvic CT examination (NOCAPE) on radiology turn around time (TAT), emergency department (ED) length of stay (LOS), and patient safety metrics. During a 12-month period at two urban teaching hospitals, 6,409 ED abdominopelvic (AP) CTs were performed to evaluate acute abdominal pain. NOCAPE represented 70.9 % of all ED AP CT examinations with intravenous contrast. Data collection included patient demographics, use of intravenous (IV) and/or oral contrast, order to complete and order to final interpretation TAT, ED LOS, admission, recall and bounce back rates, and comparison and characterization of impressions...
December 2014: Emergency Radiology
https://read.qxmd.com/read/15915410/transthecal-digital-block-an-underutilized-technique-in-the-ed
#28
REVIEW
Raymond G Hart, Francisco A S Fernandas, Joseph E Kutz
The transthecal digital block is a simple, safe, and effective anesthesia technique that can be used in many digital injuries. It is contraindicated only in cases of infection. The purposes of this article are to (1) discuss the indications for the transthecal digital block, (2) describe the technique, and (3) review the literature. The transthecal technique is used on appropriate patients almost to the exclusion of more traditional digital blocks by many hand surgeons. The advantages of this method are that it requires only a single injection, has a rapid onset of action, and requires only a small amount of anesthetic...
May 2005: American Journal of Emergency Medicine
https://read.qxmd.com/read/24769305/coronary-computed-tomography-as-a-cost-effective-test-strategy-for-coronary-artery-disease-assessment-a-systematic-review
#29
REVIEW
Irfan Zeb, Naeem Abbas, Khurram Nasir, Matthew J Budoff
Cardiovascular imaging imparts a huge burden on healthcare spending. Coronary CT angiography (CCTA) may provide a cost effective means of diagnosing coronary artery disease (CAD) and reducing downstream cost of testing. We performed a systematic search of literature for randomized controlled trials or prospective or retrospective non-randomized comparative studies or case series, decision analytic models and technology reports in which some or all of the patients underwent CCTA and looking at the cost effectiveness, comparative effectiveness and downstream test utilization associated with the use of CCTA...
June 2014: Atherosclerosis
https://read.qxmd.com/read/24730399/topical-tetracaine-used-for-24-hours-is-safe-and-rated-highly-effective-by-patients-for-the-treatment-of-pain-caused-by-corneal-abrasions-a-double-blind-randomized-clinical-trial
#30
RANDOMIZED CONTROLLED TRIAL
Neil Waldman, Ian K Densie, Peter Herbison
OBJECTIVES: The objective of this study was to test the hypothesis that topical tetracaine would be safe to use for 24 hours and would not affect corneal healing, that patients would experience more pain relief, and that patients would perceive tetracaine to be more effective than saline eye drops for the treatment of pain caused by corneal abrasions. METHODS: The study was a 12-month, prospective, double-blind, randomized trial of tetracaine versus saline set in the emergency department (ED) of a regional tertiary care teaching hospital...
April 2014: Academic Emergency Medicine
https://read.qxmd.com/read/24725226/biphasic-anaphylactic-reactions-occurrence-and-mortality
#31
JOURNAL ARTICLE
M Rohacek, H Edenhofer, A Bircher, R Bingisser
BACKGROUND: Monitoring after complete resolution of anaphylactic reactions is recommended. The aim of this study was to define the occurrence of biphasic - and clinically important biphasic - anaphylactic reactions, the number of transfers to intensive care units (ICU) because of anaphylaxis, and the number of deaths within 10 days of presentation to the emergency department (ED). METHODS: Clinical records of patients visiting the ED of a tertiary care hospital were analysed retrospectively...
June 2014: Allergy
https://read.qxmd.com/read/24947530/practice-guidelines-for-the-diagnosis-and-management-of-skin-and-soft-tissue-infections-2014-update-by-the-infectious-diseases-society-of-america
#32
JOURNAL ARTICLE
Dennis L Stevens, Alan L Bisno, Henry F Chambers, E Patchen Dellinger, Ellie J C Goldstein, Sherwood L Gorbach, Jan V Hirschmann, Sheldon L Kaplan, Jose G Montoya, James C Wade
A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis...
July 15, 2014: Clinical Infectious Diseases
https://read.qxmd.com/read/25033747/use-of-esmolol-after-failure-of-standard-cardiopulmonary-resuscitation-to-treat-patients-with-refractory-ventricular-fibrillation
#33
JOURNAL ARTICLE
Brian E Driver, Guillaume Debaty, David W Plummer, Stephen W Smith
INTRODUCTION: We compare the outcomes for patients who received esmolol to those who did not receive esmolol during refractory ventricular fibrillation (RVF) in the emergency department (ED). METHODS: A retrospective investigation in an urban academic ED of patients between January 2011 and January 2014 of patients with out-of-hospital or ED cardiac arrest (CA) with an initial rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT) who received at least three defibrillation attempts, 300mg of amiodarone, and 3mg of adrenaline, and who remained in CA upon ED arrival...
October 2014: Resuscitation
https://read.qxmd.com/read/24875895/what-is-the-best-first-line-agent-for-benzodiazepine-resistant-convulsive-status-epilepticus
#34
COMMENT
Rachel Berkowitz, Alex Koyfman
No abstract text is available yet for this article.
December 2014: Annals of Emergency Medicine
https://read.qxmd.com/read/22809915/the-risk-of-catheter-related-bloodstream-infection-with-femoral-venous-catheters-as-compared-to-subclavian-and-internal-jugular-venous-catheters-a-systematic-review-of-the-literature-and-meta-analysis
#35
REVIEW
Paul E Marik, Mark Flemmer, Wendy Harrison
BACKGROUND: Catheter-related bloodstream infections are an important cause of morbidity and mortality in hospitalized patients. Current guidelines recommend that femoral venous access should be avoided to reduce this complication (1A recommendation). However, the risk of catheter-related bloodstream infections from femoral as compared to subclavian and internal jugular venous catheterization has not been systematically reviewed. OBJECTIVE: A systematic review of the literature to determine the risk of catheter-related bloodstream infections related to nontunneled central venous catheters inserted at the femoral site as compared to subclavian and internal jugular placement...
August 2012: Critical Care Medicine
https://read.qxmd.com/read/24930444/do-hemolyzed-potassium-specimens-need-to-be-repeated
#36
JOURNAL ARTICLE
Boris Khodorkovsky, Bartholomew Cambria, Martin Lesser, Barry Hahn
BACKGROUND: In the emergency department (ED), hyperkalemia in the presence of hemolysis is common. Elevated hemolyzed potassium levels are often repeated by emergency physicians to confirm pseudohyperkalemia and to exclude a life-threatening true hyperkalemia. OBJECTIVES: We hypothesize that in patients with a normal renal function, elevated hemolyzed potassium, and normal electrocardiogram (ECG), there may not be a need for further treatment or repeat testing and increased length of stay...
September 2014: Journal of Emergency Medicine
https://read.qxmd.com/read/23801105/cardiopulmonary-resuscitation-quality-corrected-improving-cardiac-resuscitation-outcomes-both-inside-and-outside-the-hospital-a-consensus-statement-from-the-american-heart-association
#37
JOURNAL ARTICLE
Peter A Meaney, Bentley J Bobrow, Mary E Mancini, Jim Christenson, Allan R de Caen, Farhan Bhanji, Benjamin S Abella, Monica E Kleinman, Dana P Edelson, Robert A Berg, Tom P Aufderheide, Venu Menon, Marion Leary
The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement...
July 23, 2013: Circulation
https://read.qxmd.com/read/24515516/dexamethasone-for-acute-asthma-exacerbations-in-children-a-meta-analysis
#38
REVIEW
Grant E Keeney, Matthew P Gray, Andrea K Morrison, Michael N Levas, Elizabeth A Kessler, Garick D Hill, Marc H Gorelick, Jeffrey L Jackson
BACKGROUND AND OBJECTIVE: Dexamethasone has been proposed as an equivalent therapy to prednisone/prednisolone for acute asthma exacerbations in pediatric patients. Although multiple small trials exist, clear consensus data are lacking. This systematic review and meta-analysis aimed to determine whether intramuscular or oral dexamethasone is equivalent or superior to a 5-day course of oral prednisone or prednisolone. The primary outcome of interest was return visits or hospital readmissions...
March 2014: Pediatrics
https://read.qxmd.com/read/25003654/isolated-loss-of-consciousness-in-children-with-minor-blunt-head-trauma
#39
MULTICENTER STUDY
Lois K Lee, David Monroe, Michael C Bachman, Todd F Glass, Prashant V Mahajan, Arthur Cooper, Rachel M Stanley, Michelle Miskin, Peter S Dayan, James F Holmes, Nathan Kuppermann
IMPORTANCE: A history of loss of consciousness (LOC) is frequently a driving factor for computed tomography use in the emergency department evaluation of children with blunt head trauma. Computed tomography carries a nonnegligible risk for lethal radiation-induced malignancy. The Pediatric Emergency Care Applied Research Network (PECARN) derived 2 age-specific prediction rules with 6 variables for clinically important traumatic brain injury (ciTBI), which included LOC as one of the risk factors...
September 2014: JAMA Pediatrics
https://read.qxmd.com/read/25064742/the-effect-of-ketamine-on-intracranial-and-cerebral-perfusion-pressure-and-health-outcomes-a-systematic-review
#40
REVIEW
Lindsay Cohen, Valerie Athaide, Maeve E Wickham, Mary M Doyle-Waters, Nicholas G W Rose, Corinne M Hohl
STUDY OBJECTIVE: We synthesize the available evidence on the effect of ketamine on intracranial and cerebral perfusion pressures, neurologic outcomes, ICU length of stay, and mortality. METHODS: We developed a systematic search strategy and applied it to 6 electronic reference databases. We completed a gray literature search and searched medical journals as well as the bibliographies of relevant articles. We included randomized and nonrandomized prospective studies that compared the effect of ketamine with another intravenous sedative in intubated patients and reported at least 1 outcome of interest...
January 2015: Annals of Emergency Medicine
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