Annals of emergency medicine
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Randomized Controlled Trial
A randomized clinical trial comparing oral, aerosolized intranasal, and aerosolized buccal midazolam.
We determine whether aerosolized intranasal or buccal midazolam reduces the distress of pediatric laceration repair compared with oral midazolam. ⋯ When comparing the administration of midazolam by 3 routes to facilitate pediatric laceration repair, we observed slightly less distress in the aerosolized buccal group. The intranasal route demonstrated a greater proportion of patients with optimal activity scores, greater proportions of parents wanting similar sedation in the future, and faster onset but was also the most poorly tolerated at administration. Aerosolized buccal or intranasal midazolam represents an effective and useful alternative to oral midazolam for sedation for laceration repair.
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Our primary objective is to calculate the relative risk of cardiac arrests at the development guide plan (DGP) (equivalent to census tract) level in a city-state, Singapore, and examine its relationship with key area-level population characteristics. ⋯ The risk of cardiac arrests could be related to the age and racial and family structure of DGPs in Singapore. This article models how such data can help to direct public health education, cardiopulmonary resuscitation training, and public access defibrillation programs in other health systems.
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Some have suggested that emergency department (ED) boarding is prevalent because it maximizes revenue as hospitals prioritize non-ED admissions, which reimburse higher than ED admissions. We explore the revenue implications to the overall hospital of reducing boarding in the ED. ⋯ Dynamic inpatient bed management in inner-city teaching hospitals in which non-ED admissions are occasionally reduced to ensure that EDs have reduced boarding times is a financially attractive strategy.