Annals of emergency medicine
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Meta Analysis
Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature.
There is some evidence that magnesium, when infused into asthmatic patients, can produce bronchodilation in addition to that obtained from standard treatments. This systematic review examined the effect of intravenous magnesium sulfate used for patients with acute asthma managed in the emergency department. ⋯ Current evidence does not clearly support routine use of intravenous magnesium sulfate in all patients with acute asthma presenting to the ED. However, magnesium sulfate appears to be safe and beneficial for patients who present with severe acute asthma. Practice guidelines need to be changed to reflect these results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous versus intermittent nebulization of salbutamol in acute severe asthma: a randomized, controlled trial.
This study was conducted to compare the clinical and spirometric effects of continuous and intermittent nebulization of salbutamol in acute severe asthma. ⋯ We did not observe an appreciable difference between continuous and intermittent nebulization of salbutamol in acute severe asthma. The decision to use one of these nebulization methods should be based on logistical considerations.
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Although several trials have been published evaluating intravenous magnesium sulfate as treatment for acute bronchospasm, its effectiveness for this indication remains unclear, prompting this meta-analysis. ⋯ Adjuvant bolus intravenous magnesium sulfate in acute bronchospasm appears statistically beneficial in improving spirometric airway function by 16% of a SD. Although the clinical significance of this is uncertain, given the safety of intravenous magnesium sulfate therapy and its relatively low cost, it should be considered, absent contraindications, in patients with moderate to severe acute bronchospasm.
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The Veterans Health Administration (VHA) has been increasingly called on to provide disaster relief health care personnel and other emergency assistance since the role of the Department of Veterans Affairs in emergency management was expanded by the Federal Response Plan in 1992. This article briefly reviews the VHA's emergency management functions currently specified by the Federal Response Plan and its present activities in procuring and maintaining antidotes, antibiotics, and other pharmaceutical stockpiles to be used in response to terrorist incidents involving weapons of mass destruction. In view of VHA's national scope and extensive assets, its administration by the government, and its critical role in health professional training, there are several additional ways that VHA could economically augment the federal government's efforts to better support and prepare local jurisdictions for disasters or incidents involving weapons of mass destruction, if the required authorization and funding were provided.