Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Does exogenous melatonin improve day sleep or night alertness in emergency physicians working night shifts?
To determine whether exogenous melatonin improves day sleep or night alertness in emergency physicians working night shifts. ⋯ Exogenous melatonin may be of modest benefit to emergency physicians working night shifts.
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We describe seven patients presenting with combination substance abuse involving γ-Hydroxybutyric acid (GHB). ⋯ Emergency physicians should be alerted to this agent, its characteristic effects, and its potential for serious sequelae including respiratory arrest and death. [Li J, Stokes SA, Woeckener A: A tale of novel intoxication: Seven cases of γ-Hydroxybutyric acid overdose. Ann Emerg Med June 1998;31:723-728.].
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To describe the clinical characteristics and course of γ-hydroxybutyrate (GHB) overdose. ⋯ In our study population, patients who overdosed on GHB presented with a markedly decreased level of consciousness. Coingestion of ethanol or other drugs is common, as are bradycardia, hypothermia, respiratory acidosis, and emesis. Hypotension occurs occasionally. Patients typically regain consciousness spontaneously within 5 hours of the ingestion. [Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD: Clinical course of γ-hydroxybutyrate overdose. Ann Emerg Med June 1998;31: 716-722.].
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Case Reports
Intramuscular ketamine for pediatric sedation in the emergency department: safety profile in 1,022 cases.
To determine the safety of intramuscular ketamine when administered by emergency physicians for pediatric procedures in accordance with a defined protocol. ⋯ Intramuscular ketamine may be administered safely by emergency physicians to facilitate pediatric procedures in accordance with a defined protocol and with appropriate monitoring. Ketamine is highly effective, has a wide margin of safety, does not require intravenous access, and uniquely preserves protective airway reflexes.