Annals of emergency medicine
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Randomized Controlled Trial
Randomized clinical trial comparing the safety and efficacy of a hydromorphone titration protocol to usual care in the management of adult emergency department patients with acute severe pain.
We test the efficacy and safety of the "1+1" (1 mg plus 1 mg 15 minutes later if needed) hydromorphone protocol against usual care of emergency department (ED) patients with acute severe pain. ⋯ When analyzed per protocol or with the more conservative intention-to-treat analysis, the 1+1 hydromorphone protocol is statistically and clinically more efficacious than usual care. Safety profiles were similar in both groups.
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Randomized Controlled Trial
The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial.
We determine whether high-flow oxygen reduces the incidence of hypoxia by 20% in adults receiving propofol for emergency department (ED) sedation compared with room air. ⋯ High-flow oxygen reduces the frequency of hypoxia during ED propofol sedation in adults.
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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.