Annals of emergency medicine
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To determine how often pelvic ultrasonography diagnoses or excludes ectopic pregnancy (EP) in patients who present with abdominal pain or vaginal bleeding and a beta-human chorionic gonadotropin (beta-hCG) level lower than 1,000 mIU/mL. ⋯ Approximately one third of women with EP who present with beta-hCG values lower than 1,000 mIU/mL were identified with an urgent transvaginal ultrasound examination performed by trained ultrasound technicians. Clinicians should consider the use of pelvic ultrasound in patients with suspected EP, regardless of their beta-hCG values, particularly at institutions where ultrasound is readily available.
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Randomized Controlled Trial Clinical Trial
EMLA versus TAC for topical anesthesia of extremity wounds in children.
To compare the anesthetic efficacy of EMLA (eutectic mixture of local anesthetics) cream with that of TAC (tetracaine, adrenaline, and cocaine) solution for suturing uncomplicated extremity wounds. ⋯ EMLA appears to be superior to TAC for anesthesia of simple extremity lacerations in that those wounds treated with EMLA required supplemental anesthesia less often. EMLA required approximately 1 hour to cause optimal anesthesia in open wounds. Protocols should be developed to allow efficient use of EMLA for anesthesia of extremity lacerations in the ED.
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Clinical Trial
Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest.
To examine the effects of moderate hypothermia (33 degrees C), induced by surface cooling in the ED and maintained for 12 hours in the ICU, on patients with anoxic brain injury after out-of-hospital cardiac arrest. ⋯ Compared with historical normothermic controls, outcome was significantly improved and there was no increase in complications when moderate hypothermia was induced in comatose survivors of out-of-hospital cardiac arrest and maintained for 12 hours. Larger, prospective, randomized, controlled studies of induced moderate hypothermia in comatose survivors of out-of-hospital cardiac arrest are warranted.
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Comparative Study
Analysis of parental estimates of children's weights in the ED.
To assess the ability of parents to estimate their children's weight. ⋯ In 80% of cases, the parental estimate of the child's weight was within 10% of the measured weight. The parental estimate was more accurate than the formula-derived weight.