The American journal of emergency medicine
-
Randomized Controlled Trial Multicenter Study
Ketoprofen gel improves low back pain in addition to intravenous dexketoprofen: a randomized placebo-controlled trial.
Oligoanalgesia is common in emergency departments (EDs), and pain management is of concern for ED physicians. The aim of this study was to reveal the effect of ketoprofen gel in patients presenting with mechanical low back pain to the ED. ⋯ Ketoprofen gel improves pain in patients presenting with mechanical low back pain to ED at 30 minutes in addition to intravenous dexketoprofen when compared to placebo.
-
Multicenter Study Observational Study
Routine biological tests in self-poisoning patients: results from an observational prospective multicenter study.
Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied. ⋯ Routine biological tests are commonly prescribed in nonsevere self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited.
-
A free webPOISONCONTROL app allows the public to determine the appropriate triage of poison ingestions without calling poison control. If accepted and safe, this alternative expands access to reliable poison control services to those who prefer the Internet over the telephone. This study assesses feasibility, safety, and user-acceptance of automated online triage of asymptomatic, nonsuicidal poison ingestion cases. ⋯ webPOISONCONTROL augments traditional poison control services by providing automated, accurate online access to case-specific triage and first aid guidance for poison ingestions. It is safe, quick, and easy to use.
-
Randomized Controlled Trial
A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study.
Prehospital tracheal intubation by paramedics during cardiopulmonary resuscitation (CPR) in children is challenging. The potential role of new intubation devices during CPR is unclear. Our objective was to assess the impact of CPR (with and without chest compressions [CCs]) on the success and time to intubation (TTI) with the Macintosh laryngoscope vs the McGrath video laryngoscope on a pediatric manikin. ⋯ McGrath video laryngoscope helps paramedics to intubate a pediatric manikin in a CPR scenario in less time and with fewer attempts than with the classical Macintosh, both in case of ongoing or stopped CC. McGrath use in actual patients could improve CPR quality by paramedics.
-
Multicenter Study
Health care-associated acute pyelonephritis is associated with inappropriate empiric antibiotic therapy in the ED.
Acute pyelonephritis (APN) is one of the most common bacterial infections. Because health care-associated (HCA) infections in the community setting have similar characteristics to hospital-acquired infections, HCA infections should be distinguished from community-acquired (CA) infections. However, the impact of HCA-APN on treatment outcomes has not been clearly defined. This study aimed to analyze the impact of HCA-APN on the appropriateness of empiric antibiotic therapy and outcomes in community-onset APN. ⋯ Health care-associated APN was associated with inappropriate empiric antibiotic therapy, which might lead to worse outcomes. These HCA factors should be considered when prescribing empiric antibiotic therapy in patients with community-onset APN.