The American journal of emergency medicine
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Review Meta Analysis Comparative Study
Intranasal ketamine for acute pain management in children: A systematic review and meta-analysis.
To assess the efficacy and safety of intranasal analgesic-dose ketamine as compared to intranasal fentanyl for pediatric acute pain. ⋯ Intranasal analgesic-dose ketamine may be considered as an alternative to opioids for acute pain management in children. Its accepted use will depend on the tolerability of non-serious adverse events and the desire to avoid opioids.
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Multicenter Study
The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States.
COVID-19 pandemic effects are still being elucidated. Stay-at-home orders and social distancing compounded with COVID-19 concerns have caused significant disruptions in daily life. One notable effect of these variables may be a change in the number of emergency department (ED) visits. This study aims to investigate the effects of COVID-19 on ED visits, and possible reasons for changes. ⋯ A number of factors have likely contributed to the substantial decrease in ED visits observed in this study. In light of these findings, it is important to raise patient awareness regarding acute conditions that are deadlier than COVID-19 and require immediate medical intervention to ensure recovery.
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Case Reports
Hypoglycemic cardiac arrest and rapid return-of-spontaneous circulation (ROSC) with dextrose - A case report.
Hypoglycemia was part of the "H's and T's" in the 2005 American Heart Association ACLS guidelines for reversible causes of cardiac arrest but was removed in subsequent editions. We present a case of return of spontaneous circulation in a patient with cardiac arrest after administration of dextrose for hypoglycemia. Routine administration of dextrose to patients in cardiac arrest has been shown to be associated with increased mortality and worse neurological outcomes. However, this case reminds the clinician to consider hypoglycemia in patients with cardiac arrest, and to attempt correcting a low blood glucose if noted.