The American journal of emergency medicine
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Comparative Study
Women are less likely than men to receive prehospital analgesia for isolated extremity injuries.
The goal of this study was to examine the effect of socioeconomic factors, such as ethnicity, income, age, and sex, on the administration of analgesia for isolated extremity injuries in the prehospital setting. ⋯ This study suggests that women are less likely than men to receive prehospital analgesia for isolated extremity injuries. Patients with higher pain severity and longer duration of prehospital care are more likely to receive prehospital analgesia. Increasing levels of income were associated with increased rates of analgesia. The overall rate of prehospital analgesia administration for isolated extremity injuries in this population is higher than has been reported for other emergency medical services systems (29% vs 2%-18% in other recent studies), but there remains considerable room for improvement in the provision of prehospital analgesia. Further inquiry is needed to determine why certain populations such as women receive disproportionately less analgesia.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting.
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Comparative Study
Utility of Stewart's strong ion difference as a predictor of major injury after trauma in the ED.
Base deficit (BD) is a validated surrogate for lactate in injured patients and correlates with trauma severity. Stewart proposed a more comprehensive measure of acidosis based on the strong ion difference (SID) (SID = Na + K + Mg + Ca - CL - lactate [mEq/L]). We compared operating characteristics of BD, anion gap (AG), and SID in identifying major injury in emergency department (ED) trauma patients. ⋯ Stewart's SID can identify major injury in the ED.
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The objective of the study was to determine the sensitivity and specificity of abnormal ascitic fluid appearance in the detection of spontaneous bacterial peritonitis (SBP), as a sensitivity approaching 100% could exclude SBP if the fluid is clear. ⋯ Abnormal fluid appearance has a high sensitivity for the detection of SBP. Thus, clear fluid might safely exclude SBP.