Annals of emergency medicine
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Randomized Controlled Trial Clinical Trial
Intravenous Lorazepam versus dimenhydrinate for treatment of vertigo in the emergency department: a randomized clinical trial.
To determine whether lorazepam is more effective than dimenhydrinate in relieving the symptom of vertigo in the emergency department setting. ⋯ Our results suggest that dimenhydrinate was more effective in relieving vertigo and less sedating than lorazepam at the intravenous doses administered in this study. Dimenhydrinate appears to be the preferred medicine for patients who present to the ED with vertigo likely to be of peripheral origin.
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Comparative Study Clinical Trial Controlled Clinical Trial
Design and implementation of a controlled trial of pediatric endotracheal intubation in the out-of-hospital setting.
This article describes the design and implementation of the Pediatric Airway Management Project. The project was completed January 1, 1997, and evaluated the effectiveness of endotracheal intubation relative to bag-valve-mask ventilation in improving survival to hospital discharge and neurologic outcome in children, the effect of training on paramedic airway management skills and self-efficacy, the length of time the skills can be retained, and the costs of training and retraining. ⋯ To date, this project is the largest prospective, controlled, out-of-hospital study of the care of children ever reported. Barriers to implementation of a study of this size are described.
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Randomized Controlled Trial Clinical Trial
Effects of cervical spine immobilization technique and laryngoscope blade selection on an unstable cervical spine in a cadaver model of intubation.
Orotracheal intubation (OTI) is commonly used to establish a definitive airway in major trauma victims, with several different cervical spine immobilization techniques and laryngoscope blade types used. This experimental, randomized, crossover trial evaluated the effects of manual in-line stabilization and cervical collar immobilization and 3 different laryngoscope blades on cervical spine movement during OTI in a cadaver model of cervical spine injury. ⋯ Manual in-line stabilization results in less cervical subluxation and allows better vocal cord visualization during OTI in a cadaver model of cervical spine injury. The Miller laryngoscope blade allowed less axial distraction than the Macintosh or Corzelli-London-McCoy blades. The clinical significance of this degree of movement is unclear.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance.
This study was conducted to determine the natural history of airway management skill decay and examine the effect of independent practice and periodic feedback on airway management skill maintenance. ⋯ Airway management skill performance declines early after initial training. Independent practice combined with periodic feedback was effective in maintaining performance scores in an advanced airway management simulation. Periodic evaluation with feedback alone showed a nonsignificant trend toward improvement over control.