Annals of emergency medicine
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Comparative Study
Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning.
To test the hypothesis that venous carboxyhemoglobin (V-COHb) levels accurately predict arterial (A-COHb) levels. ⋯ Venous COHb levels predict arterial levels with a high degree of accuracy. Patients with suspected CO poisoning can be screened with the use of venous blood, without the need for arterial puncture.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Subcutaneous sumatriptan for treatment of acute migraine in patients admitted to the emergency department: a multicenter study.
To assess the efficacy of SC sumatriptan injection versus placebo in the treatment of acute migraine in ED patients and that of open-label 100 mg sumatriptan PO tablets for recurrent migraine. ⋯ Sumatriptan (6 mg SC) is effective in treating acute migraine in the ED. Oral sumatriptan (100 mg) is effective in treating headache recurrence within 24 hours.
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Randomized Controlled Trial Comparative Study Clinical Trial
Delayed neuropsychologic sequelae after carbon monoxide poisoning: prevention by treatment with hyperbaric oxygen.
Carbon monoxide (CO) poisoning is a major clinical problem. The risk of morbidity and the most effective treatment have not been clearly established. We measured the incidence of delayed neurologic sequelae (DNS) in a group of patients acutely poisoned with CO and tested the null hypothesis that the incidence would not be affected by treatment with hyperbaric oxygen (HBO). ⋯ DNS after CO poisoning cannot be predicted on the basis of a patient's clinical history or CO level. HBO treatment decreased the incidence of DNS after CO poisoning.
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One of the district and universal aspects of emergency medical service (EMS) is the belief that before its implementation many people were dying or being killed by ill-equipped, poorly trained "hearse drivers" and that this tragic state of affairs has been rectified by the advances in the prehospital phase of care. Except for cases of nontraumatic, out-of-hospital cardiac arrest there is almost no convincing scientific evidence to prove that prehospital care has had an impact on morbidity or mortality. At the very foundation of this problem is the lack of a set of broad-based, well-conceived, accurate, reliable, uniform EMS data. ⋯ In 1992, with the assistance of the National Highway Traffic Safety Administration, the national consensus process began with a series of meetings involving many EMS agencies and organizations. This culminated in August 1994 with the development of an 81-item uniform EMS data set. We detail the prior attempts at data set development and outline the process leading to the this uniform, national EMS data set.
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To determine the outcome of pediatric patients with prehospital cardiopulmonary arrest. ⋯ Most successfully resuscitated pediatric arrest victims are resuscitated in the prehospital setting and do not suffer severe neurologic injury. Most patients who present to the ED in continued arrest and survive to discharge have severe neurologic injury.