The American journal of emergency medicine
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Multicenter Study
Association of age and opioid use for adolescents and young adults in community emergency departments.
Adolescents and young adults are at high risk for opioid misuse and abuse. The emergency department (ED) plays a key role in treatment of acute and chronic pain and is a primary place that this patient population is exposed to prescription opioids. We evaluate the effect of patient age on use of opioids for adolescents and young adults in community EDs. ⋯ For adolescent and young adult patients in the ED, there is a significant association between opioid prescribing and increasing age. This describes an opportunity to reduce opioid use in older adolescents and young adults.
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Review Meta Analysis
Diagnostic value of neutrophil CD64 combined with CRP for neonatal sepsis: A meta-analysis.
Sepsis is the leading cause of morbidity and mortality in newborns. CD64 combined with c-reactive protein (CRP) could improve the sensitivity and specificity of neonatal sepsis diagnosis, but the results were still controversial. Therefore, this meta-analysis was conducted to clarify the importance of CD64 combined with CRP in the diagnosis of neonatal sepsis. ⋯ The combined application of CD64 and CRP improved the accuracy of neonatal sepsis diagnosis.
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Multicenter Study Observational Study
History and physical exam predictors of intracranial injury in the elderly fall patient: A prospective multicenter study.
A prior single-center study demonstrated historical and exam features predicting intracranial injury (ICI) in geriatric patients with low-risk falls. We sought to prospectively validate these findings in a multicenter population. ⋯ In low-risk geriatric fall patients, the best predictors of ICI were physical findings of head trauma and history of LOC.
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Patients with acute myocardial infarction (AMI) may suffer several complications after the acute event, including dysrhythmias and heart failure (HF). These complications place patients at risk for morbidity and mortality. ⋯ This review discusses considerations of ED management of dysrhythmias and HF associated with AMI.
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Randomized Controlled Trial
Comparison of the analgesic effects of haloperidol with or without morphine in patients with acute renal colic: A randomized double-blind clinical trial study.
Given the increasing number of patients with acute renal colic, the present study examined the analgesic effects of haloperidol with or without morphine in order to find an effective method with fewer side effects for pain reduction in these patients. ⋯ In our patients with acute renal colic, haloperidol failed to reduce pain and the incidence of nausea or vomiting, while it caused extrapyramidal side effects. Therefore, the prescription of this medication for acute pains, especially in renal colic, is not recommended.