Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intermittent and continuously nebulized albuterol for treatment of asthma in an urban emergency department.
To compare continuously nebulized albuterol with intermittent bolus nebulization of albuterol. ⋯ Continuous nebulization offers no benefit over intermittent therapy in patients with an initial PEFR of more than 200 L/min. In PEFRs of 200 or less, continuous nebulization may decrease admission rate and improve PEFRs when compared with standard therapy.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A clinical trial of escalating doses of flumazenil for reversal of suspected benzodiazepine overdose in the emergency department.
To determine if flumazenil, when used in doses higher than those currently recommended, could reverse the effects of a benzodiazepine (BDZ) overdose in patients who might not otherwise respond and whether the higher dose was associated with increased adverse effects. ⋯ Flumazenil rapidly and effectively reverses the clinical signs and symptoms of a BDZ overdose. Most patients will respond to 3 mg or less, but a small number may require a higher dose for reversal of clinical symptoms. Patients with concomitant tricyclic antidepressant overdose may be at risk for developing seizures.
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Sepsis and septic shock are among the most frequent life-threatening infectious disease problems encountered in emergency medicine practice. This review summarizes the extensive research into the pathophysiology of sepsis, with emphasis on Gram-negative infection. ⋯ It also critically evaluates new preparations developed to blunt the actions of the exogenous and endogenous mediators responsible for the clinical manifestations comprising this syndrome. Clinical signs likely to be associated with Gram-negative infection are also reviewed, and guidelines are considered for the potential use of newly developed anti-endotoxin antibodies and other biological response modifiers in the treatment of patients with Gram-negative sepsis.
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Editorial Comment
Data, epidemiology, and the future strength of emergency medicine.