Annals of emergency medicine
-
Randomized Controlled Trial Comparative Study Clinical Trial
Simplification of emergency department discharge instructions improves patient comprehension.
Emergency department patients have been shown to have difficulty understanding written discharge instructions. We attempted to determine whether improvements in comprehension can be achieved by simplification of available materials. ⋯ Simplified written materials may help patients who do not understand current standard materials. Health care providers should simplify written materials to make them understandable to the greatest number of patients.
-
Comparative Study
Clinical decision rules discriminate between fractures and nonfractures in acute isolated knee trauma.
To develop criteria that optimize clinical decisionmaking in the use of radiography after isolated knee trauma in adults. ⋯ Clinical decision rules are effective in detecting knee fractures with 100% sensitivity and with sufficient specificity to eliminate 29% of knee radiographs in the ED. These findings require prospective validation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized trial of epinephrine, metaproterenol, and both in the prehospital treatment of asthma in the adult patient.
To compare the effectiveness and incidence of adverse reactions with three treatment regimens for asthma in adults in the prehospital setting. ⋯ Nebulized metaproterenol is as effective as subcutaneous epinephrine in the prehospital treatment of adult patients with acute asthma. The combination of these two treatments offered no additional clinical benefit in the patients we studied.
-
To determine the spectrum of disorders in children younger than 6 years with upper-extremity injury or immobility and to identify clinical findings associated with specific disorders. ⋯ Most children with arm injury or immobility have bony or soft-tissue trauma, the majority being RHS. Clinical findings varied between diagnoses and may aid the clinician in deciding whether attempted reduction of RHS is indicated or whether radiographs are warranted first. Nontrauma diagnoses are unusual but should be considered, particularly in the child younger than 6 months old. Appropriate immobilization and follow-up are important for the management of children without a clear diagnosis at the initial evaluation.
-
Case Reports
Avulsion fracture of the anterior superior iliac spine presenting as acute-onset meralgia paresthetica.
Avulsion fracture of the anterior superior iliac spine is rare. Most cases occur in adolescents involved in competitive sports or vigorous exercise in which the sartorius and tensor fascia lata muscles are contracted strongly and suddenly against a hyperextended trunk. ⋯ We describe a patient with avulsion of the anterior superior iliac spine who presented with meralgia paresthetica. The symptoms resolved with conservative treatment.