Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Vagal response varies with Valsalva maneuver technique: a repeated-measures clinical trial in healthy subjects.
Variable success rates of the Valsalva maneuver in treatment of paroxysmal supraventricular tachycardia may be due to variations in performance technique. This study aimed to compare the magnitude of the vagal reflexes initiated by 5 variations of the Valsalva maneuver technique (supine, supine with epigastric pressure, supine with leg raise, semirecumbent position, and sitting position). ⋯ For healthy subjects in sinus rhythm, the supine with epigastric pressure and supine techniques generated stronger vagal responses, as measured by R-R intervals and pulse rates, than the other techniques examined. However, the vagal responses of these 2 techniques were similar, and the addition of epigastric pressure may confer little advantage.
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The purpose of this study is to determine what factors influence emergency physicians' decisions to prescribe an opioid analgesic for 3 common, painful conditions. ⋯ Even when faced with identical case scenarios, physicians' decisions to prescribe opioid analgesics are highly variable. Moreover, the same clinical information, such as a patient requesting a strong analgesic, changes the likelihood of prescribing opioids in opposite directions for different physicians.
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Comparative Study
Emergency medicine-trained physicians are proficient in the insertion of transvenous pacemakers.
The insertion and management of a temporary transvenous pacemaker can be a lifesaving procedure in the emergency department setting. We compare the success and complication rates associated with temporary transvenous pacemaker insertion between physicians trained in either emergency medicine or cardiology. ⋯ Physicians trained in emergency medicine perform temporary transvenous pacemaker insertions in the acute care setting with a proficiency similar to that of their counterparts in cardiology.
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Editorial Comment Comparative Study
Comparing NEXUS and Canadian C-Spine decision rules for determining the need for cervical spine radiography.
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Editorial Comment Comparative Study
Comparison of the Canadian C-Spine rule and NEXUS decision instrument in evaluating blunt trauma patients for cervical spine injury.