Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Validation of diphenhydramine as a dermal local anesthetic.
Although diphenhydramine has been recommended as an alternate local anesthetic for patients claiming allergy to lidocaine, no prior placebo-controlled evaluations of diphenhydramine for dermal anesthesia have been performed. We sought to determine the relative efficacy of diphenhydramine compared to saline placebo and lidocaine. ⋯ In this study of 24 adult volunteers, diphenhydramine 1% was as effective as lidocaine 1% for achieving dermal local anesthesia, although injection was more painful. Although no clinically important complications were noted in our study, the safety of diphenhydramine remains to be established, especially in areas with poor collateral perfusion (eg, digits, pinna, and nose).
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Randomized Controlled Trial Comparative Study Clinical Trial
1% lidocaine versus 0.5% diphenhydramine for local anesthesia in minor laceration repair.
Our previous study demonstrated that 1% diphenhydramine is as effective as 1% lidocaine for anesthesia in minor laceration repair, but that it also is more painful to inject. The purpose of this study was to compare 0.5% diphenhydramine to 1% lidocaine for pain of injection and adequacy of local anesthesia. ⋯ Although not a replacement for lidocaine, diphenhydramine is a viable alternative for anesthesia in the repair of minor lacerations.
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Comparative Study
Outcome of cardiovascular collapse in pediatric blunt trauma.
To determine the survival and functional outcome of pediatric blunt trauma victims demonstrating cardiovascular collapse, including pulseless cardiopulmonary arrest or severe hypotension, on initial presentation in an emergency department. ⋯ No child who presented with pulseless cardiac arrest or severe hypotension following blunt trauma achieved functional survival. Reimbursed care for pediatric victims of blunt trauma demonstrating cardiovascular collapse is disproportionately poor compared with that for pediatric patients who maintain hemodynamic integrity in the ED. Half of all patients who were stabilized sufficiently for transfer to the pediatric ICU were eligible potential organ donors. Therefore aggressive resuscitation of these patients may be justified if organ donation is seriously contemplated and aggressively pursued.