Annals of emergency medicine
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To determine whether the environment of a moving ambulance affects the ability of our-of-hospital care providers to auscultate breath sounds. ⋯ Assessment of breath sounds is hampered by the environment of a moving ambulance.
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To determine the asthma admission rate and the rate of repeat visits to the emergency department for asthma within 72 hours before and after the introduction of an observation unit (OU). When necessary, admission to the ward from the OU is usually made within 12 hours. ⋯ The use of an OU in the ED was associated with a reduction in the hospitalization rate for children with acute asthma exacerbation. However, we also noted an increased rate of repeat visits to the ED after the introduction of the OU.
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Randomized Controlled Trial Clinical Trial
Efficacy of nebulized ipratropium in severely asthmatic children.
To determine the effect of adding the nebulized anticholinergic drug ipratropium bromide to standard therapy compared with standard therapy alone for acute severe asthma (peak expiratory flow rate [PEFR] < 50% of predicted) in children presenting to the emergency department. ⋯ We detected significant improvement in pulmonary function studies over 120 minutes in children with severe asthma who were given nebulized ipratropium combined with albuterol and oral steroids, compared with children who received the standard therapy. Further study is needed to determine whether early use of ipratropium decreases the need for hospitalization.
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Randomized Controlled Trial Clinical Trial
Intravenous versus oral corticosteroids in the management of acute asthma in children.
To determine whether oral corticosteroids are significantly better at preventing the need for hospital admission than i.v. corticosteroids in children with moderate to severe asthma exacerbation. ⋯ These data suggest that for children with moderate to severe asthma exacerbation, hospital admission rates are similar in children given oral methylprednisolone and those given i.v. methylprednisolone.