Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Droperidol versus haloperidol for chemical restraint of agitated and combative patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Histamine antagonists in the treatment of acute allergic reactions.
We compared the efficacies of cimetidine (an H2-receptor antagonist) and diphenhydramine (an H1-receptor antagonist) alone and in combination for alleviation of symptoms of acute allergic reactions. STUDY DESIGN AND INTERVENTIONS: In this prospective, randomized, double-blind study, patients and examiners assessed the severity of symptoms and signs of acute allergic reactions using a visual-analog scale before treatment and 30 minutes after treatment with 300 mg IV cimetidine and placebo, 50 mg IV diphenhydramine and placebo, or diphenhydramine plus cimetidine. ⋯ For treatment of pruritus from acute allergic reactions, diphenhydramine is more effective than cimetidine, and the combination offers no additional benefit. For treatment of acute urticaria, the combination of cimetidine and diphenhydramine is more effective than diphenhydramine alone.
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Randomized Controlled Trial Clinical Trial
Intravenous magnesium for acute asthma: failure to decrease emergency treatment duration or need for hospitalization.
To evaluate the efficacy of routine early administration of i.v. magnesium to patients with acute asthma. ⋯ Routine early administration of IV magnesium in acute asthma does not alter treatment outcome.
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Randomized Controlled Trial Clinical Trial
Optimal patient position for transport and initial management of toxic ingestions.
Many factors influence the rate of gastric emptying and therefore the rate of drug absorption in the orally poisoned patient. Limited studies have evaluated the effect of body position on the rate of gastric emptying of radiographically marked foods and contrast media, but effects on drug absorption have not been studied previously. Our hypothesis was that body position would have an effect on the rate of drug absorption in an oral overdose model. ⋯ Initial drug absorption as determined by two-hour AUC was lowest in the left lateral decubitus position. Although the difference between the left lateral decubitus and supine positions did not reach statistical significance, both left lateral decubitus and supine were significantly lower than three other common patient body positions tested. Because the left lateral decubitus position has other advantages (eg, prevention of aspiration) in addition to minimizing drug absorption, we recommend that orally poisoned patients be placed in the left lateral decubitus position for prehospital and initial ED management.
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Randomized Controlled Trial Clinical Trial
Buffered lidocaine as a local anesthetic: an investigation of shelf life.
To determine whether buffered lidocaine must be prepared just before use. ⋯ Buffered lidocaine stays effective for up to one week after preparation. It is therefore convenient to use in emergency settings.