Annals of emergency medicine
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Randomized Controlled Trial Multicenter Study
Acetaminophen or Nonsteroidal Anti-Inflammatory Drugs in Acute Musculoskeletal Trauma: A Multicenter, Double-Blind, Randomized, Clinical Trial.
We determine whether pain treatment with acetaminophen was not inferior to nonsteroidal anti-inflammatory drugs or the combination of both in minor musculoskeletal trauma. ⋯ Pain treatment with acetaminophen was not inferior to that with diclofenac or the combination of acetaminophen and diclofenac in acute minor musculoskeletal extremity trauma, both in rest and with movement.
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Randomized Controlled Trial Multicenter Study
Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask.
Nonrebreather masks and bag-valve masks are used for preoxygenation before emergency intubation. Flush rate oxygen delivered with a nonrebreather mask is noninferior to bag-valve mask oxygen at 15 L/min. We seek to compare the nonrebreather mask with flush rate oxygen to a bag-valve mask with flush rate oxygen (with and without inspiratory assistance) and determine whether the efficacy of bag-valve mask with flush rate oxygen is compromised by a simulated mask leak. ⋯ With flush rate oxygen, the nonrebreather mask is noninferior to the bag-valve mask, with and without inspiratory assistance. Bag-valve mask performed poorly with a mask leak, even with flush rate oxygen. Flush rate oxygen with a nonrebreather mask is a reasonable default preoxygenation method in spontaneously breathing patients with no underlying respiratory pathology.
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Multicenter Study
Opioid Prescribing for Opioid-Naive Patients in Emergency Departments and Other Settings: Characteristics of Prescriptions and Association With Long-Term Use.
We explore the emergency department (ED) contribution to prescription opioid use for opioid-naive patients by comparing the guideline concordance of ED prescriptions with those attributed to other settings and the risk of patients' continuing long-term opioid use. ⋯ Compared with non-ED settings, opioid prescriptions provided to opioid-naive patients in the ED were more likely to align with CDC recommendations. They were shorter, written for lower daily doses, and less likely to be for long-acting formulations. Prescriptions from the ED are associated with a lower risk of progression to long-term use.