The American journal of emergency medicine
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Case Reports
Delayed salicylate toxicity with undetectable initial levels after large-dose aspirin ingestion.
Aspirin (acetylsalicylic acid), the most commonly used medicinal salicylate, is an antiinflammatory, antipyretic, antirheumatic, and analgesic agent. In 2005, according to the Toxic Exposures Survey from the American Association of Poison Control Centers' National Poisoning and Exposure Database, there were more than 20,000 reported aspirin and nonaspirin salicylate exposures, 64% of which required treatment in a health care facility. Of these exposures, 50% were reported as intentional overdoses and 60 patients died.
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Randomized Controlled Trial Comparative Study
Comparison of hypertonic vs isotonic fluids during resuscitation of severely burned patients.
The hypertonic lactate saline (HLS) solutions with mild concentration of sodium have been used in some burn centers to maintain plasma volume without infusing larger fluids volumes. To evaluate the fluid requirements during resuscitation with lactated Ringer's solution and to realize resuscitation with HLS, we suggest the following clinical trial. Specific objectives include fluid loads, sodium loads, and fluid accumulation. ⋯ Hypertonic resuscitation consists in giving a higher fluid and sodium load in the first hour of therapy that is accompanied with a decrease in fluid requirements and fluid accumulation for the first 24 hours of burn shock.
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Randomized Controlled Trial
Comparison of chest compression kinematics associated with over-the-head and standard cardiopulmonary resuscitation.
Over-the-head cardiopulmonary resuscitation (CPR) is a method of chest compression, which may be easier to perform than standard CPR in a confined space. ⋯ There were no differences between the kinematics, compression forces, depths, and frequencies obtained using the O and S CPR methods as practiced by experienced providers.
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The aim of this study is to report the usability of our modified hair apposition technique (modHAT) in repairing scalp lacerations. ⋯ Most scalp lacerations can be repaired with the modHAT technique primarily. Care should be taken to apply the glue to the twist of hair only and avoid excess glue running onto the scalp or into the wound. Wider use of this inexpensive, quick technique should be encouraged.
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The digital rectal examination (DRE) is commonly recommended in the evaluation of individuals with undifferentiated abdominal pain (UAP) despite negligible evidence. We aimed to determine its clinical utility. ⋯ Differential diagnosis was unaffected in most subjects undergoing DRE, and it appears as likely to be harmful as helpful in predicting final diagnosis. Given the discomfort and minimal predictive value of the DRE in this setting, highly selective use seems reasonable.