The American journal of emergency medicine
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Observational Study
A prospective study of suicide screening tools and their association with near-term adverse events in the ED.
The goal of this study was to evaluate the relationship between various suicide screening tools and clinical impression with subsequent patient psychiatric admission and near-term adverse emergency department (ED) events. ⋯ Clinical impression alone and the suicide screening tools showed poor predictive value for near-term events. Data from this study highlight the need for the development of ED-based suicide screening instruments capable of identifying those patients with suicidal ideation at greatest risk.
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Observational Study
Lack of adverse effects from flumazenil administration: an ED observational study.
Flumazenil is an effective benzodiazepine (BZD) antagonist. Empiric use of flumazenil in the emergency department (ED) is not widely recommended due to concerns of seizures, which are commonly associated with coingestants and BZD withdrawal. ⋯ A majority of patients had improved mental status after the administration of flumazenil. No patient experienced seizures. Additional studies that clarify the role of flumazenil for ED patients with suspected BZD toxicity are warranted.
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Review Meta Analysis
Effects of sniffing position for tracheal intubation: a meta-analysis of randomized controlled trials.
The purpose of this meta-analysis was to validate the efficacy of the sniffing position in the performance of intubation with direct laryngoscopy. ⋯ Compared with the other head positions, the sniffing position did not improve glottic visualization, success rate of the first intubation, or intubation time. However, the sniffing position was significantly associated with better Intubation Difficulty Scale compared with the simple head extension position. (RR,1.28; 95% CI, 1.15-1.42; p<0.0001) CONCLUSIONS: Although patients do not benefit from the sniffing position in terms of glottic visualization, success rate of the first intubation, or intubation time, the sniffing position can still be recommended as the initial head position for tracheal intubation because the sniffing position provides easier intubation conditions.
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Randomized Controlled Trial Comparative Study
Efficacy and safety of nebulized morphine given at 2 different doses compared to intravenous titrated morphine in trauma pain.
Our aim was to compare the efficacy and safety of intravenous (IV) titrated morphine with nebulized morphine given at 2 different doses in severe traumatic pain. ⋯ Nebulized morphine using boluses of 10 mg has similar efficacy and better safety than IV titrated morphine in patients with severe posttraumatic pain. Increasing nebulized boluses to 20 mg increases the effectiveness without increasing side effects.