Annals of emergency medicine
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Review Meta Analysis
Systematic review and meta-analysis of the effect of warming local anesthetics on injection pain.
Local anesthetics are the main class of analgesics used for pain management during laceration repair and other minor surgeries; however, they are administered by injection, which is painful. Warming local anesthetics has been proposed as a cost-free intervention that reduces injection pain. A systematic review of the effectiveness of this technique has not yet been undertaken. We determine the effectiveness of warming local anesthetics to reduce pain in adults and children undergoing local anesthetic infiltration into intradermal or subcutaneous tissue. ⋯ Warming local anesthetics leads to less pain during injection and therefore should be done before administration.
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Meta Analysis
Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis.
Ectopic pregnancy is a common concern in emergency departments (EDs) and remains the leading cause of first-trimester mortality. Pelvic ultrasonography by emergency physicians has been investigated as a diagnostic test for ectopic pregnancy. We present a meta-analysis of the use of emergency physician ultrasonography in the evaluation of patients at risk of ectopic pregnancy. ⋯ The results of this meta-analysis suggest that in a wide variety of clinical settings, the use of bedside ultrasonography performed by emergency physicians as a diagnostic test for ectopic pregnancy provides excellent sensitivity and negative predictive value. Visualization of an intrauterine pregnancy by an emergency physician is generally sufficient to rule out ectopic pregnancy.
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Review Meta Analysis
Accuracy and quality of clinical decision rules for syncope in the emergency department: a systematic review and meta-analysis.
We assess the methodological quality and prognostic accuracy of clinical decision rules in emergency department (ED) syncope patients. ⋯ The methodological quality and prognostic accuracy of clinical decision rules for syncope are limited. Differences in study design and ECG interpretation may account for the variable prognostic performance of the San Francisco Syncope Rule when validated in different practice settings.
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Review Meta Analysis
Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review.
We seek to determine the diagnostic test characteristics of noncontrast computed tomography (CT) for appendicitis in the adult emergency department (ED) population. ⋯ We found the diagnostic accuracy of noncontrast CT for the diagnosis of acute appendicitis in the adult population to be adequate for clinical decisionmaking in the ED setting.