The American journal of emergency medicine
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Randomized Controlled Trial Comparative Study
Comparison of success and pain levels of supination-flexion and hyperpronation maneuvers in childhood nursemaid's elbow cases.
The aim of this study was to compare the hyperpronation (HP) and the supination-flexion (SF) reduction techniques for reducing nursemaid's elbow in terms of efficacy and pain. ⋯ The HP technique was found to be more successful compared with the SF technique in achieving reduction. We were unable to find any significant difference in pain levels observed between the 2 techniques.
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Comparative Study Clinical Trial
Non-invasive blood pressure and cardiac index measurements using the Finapres Portapres in an emergency department triage setting.
Emergency department (ED) patients are triaged to determine the urgency of care. The Finapres Portapres (FP) measures blood pressure (BP) and cardiac output (CO) non-invasively, and may be of added value in early detection of patients at risk for hemodynamic compromise. ⋯ When used as a triage device in the emergency department setting, non-invasive BP measurements using FP do not correlate well with automated sphygmomanometry. However, this study does indicate that use of the FP device in triage may aid physicians to recognize patients in early phases of shock.
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Comparative Study
Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting.
Recent drug shortages have required the occasional replacement of etomidate for endotracheal intubation (ETI) by helicopter emergency medical services (HEMS), with ketamine. The purpose of this study was to assess whether there was an association between ketamine vs etomidate use as the main ETI drug, with hemodynamic or clinical (airway) end points. ⋯ Initial assessment of ETI success and complication rates, as well as peri-ETI hemodynamic changes, suggests no concerning complications associated with large-scale replacement of etomidate with ketamine as the major airway management drug for HEMS.
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Comparative Study Clinical Trial
Evaluation of the Mortality in Emergency Department Sepsis score combined with procalcitonin in septic patients.
To determine an effective method for predicting severity of sepsis and 28-day mortality of emergency department (ED) patients, we compared the Mortality in Emergency Department Sepsis (MEDS) score with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) and evaluated the MEDS score combined with relevant biomarkers. ⋯ The predictive ability of the MEDS score for severity and 28-day mortality of septic ED patients is better than PCT, IL-6, and CRP levels. The MEDS score combined with PCT enhances the ability of risk stratification and prognostic evaluation.
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Comparative Study Clinical Trial
Prognostic value of adrenomedullin in septic patients in the ED.
The aims of the present study were to evaluate the prognostic value of adrenomedullin (AM) in septic patients in the emergency department (ED) and to compare it with procalcitonin (PCT) and Mortality in Emergency Department Sepsis (MEDS) score. ⋯ Adrenomedullin is valuable for prognosis in septic patients in the ED.