Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Nebulized dexamethasone versus oral prednisone in the emergency treatment of asthmatic children.
To compare nebulized dexamethasone with oral prednisone in the treatment of children with asthma. ⋯ Nebulized dexamethasone was as effective as oral prednisone in the ED treatment of moderately ill children with acute asthma and was associated with more rapid clinical improvement, more reliable drug delivery, and fewer relapses.
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Comparative Study
Gender-associated differences in emergency department pain management.
To determine whether patient or provider gender is associated with the number, type, and strength of medications received by emergency department patients with headache, neck pain, or back pain. ⋯ Female patients with headache, neck pain, or back pain describe more pain and are perceived by providers to have more pain than male patients in the ED. Female patients also receive more medications and stronger analgesics. In this study, severity of patient pain rather than gender stereotyping appeared to correlate most with pain-management practices.
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To derive a highly sensitive decision rule for the selective use of radiography in acute knee injuries. ⋯ A practical, highly sensitive, and reliable decision rule for the use of radiography in acute knee injuries has been derived. Clinical application should await prospective validation of the rule.
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Comparative Study
Can a day 4 bone scan accurately determine the presence or absence of scaphoid fracture?
To evaluate the accuracy of day 4 bone scans in predicting the presence or absence of fracture in patients with "clinical scaphoid fracture." ⋯ Day 4 bone scans are an accurate means of ruling out scaphoid fracture. However, because of a significant number of false-positive scans at day 4, they do not reliably confirm the diagnosis of scaphoid fracture. The bone scans also permitted identification of several other wrist fractures that had not been radiographically apparent.