The American journal of emergency medicine
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Meta Analysis
Association of acute kidney injury with the severity and mortality of SARS-CoV-2 infection: A meta-analysis.
we aimed to explore the relationship of acute kidney injury (AKI) with the severity and mortality of coronavirus disease 2019 (COVID-19). ⋯ AKI is closely related with severity and mortality of COVID-19, which gives awareness for doctors to pay more attention for risk screening, early identification and timely treatment of AKI.
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Multicenter Study
The effects of a morphine shortage on emergency department pain control.
In 2018, due to a national morphine shortage, our two study emergency departments (EDs) were unable to administer intravenous (IV) morphine for over six months. We evaluated the effects of this shortage on analgesia and patient disposition. ⋯ Removing IV morphine in the ED, without a compensatory rise in alternative opioids, does not appear to significantly impact analgesia or disposition. These data favor a more limited opioid use strategy in the ED.
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Randomized Controlled Trial Multicenter Study
Emergency physician performed ultrasound-assisted lumbar puncture in children: A randomized controlled trial.
Lumbar puncture (LP) is one of the most common procedures performed in pediatric emergency departments but first-attempt success rates remain low and traumatic LP remains frequent. The aim of this study was to determine if ultrasound performed by emergency physicians improves the probability of first-attempt success for lumbar puncture in children. ⋯ Our study does not support the routine use of ultrasound for performing lumbar puncture in children. Considering the minimal harm and ease of performance, ultrasound may be used as an adjunct and teaching tool in certain clinical situations.
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Randomized Controlled Trial
CPR by foot. An alternative in special circumstances? A randomized simulation study.
To assess the differences in the quality and self-perception of CPR performed with foot technique compared to the standard technique with the hands in nursing students. ⋯ CPR quality was lower when performing foot technique, although with positive results. It would be advisable for people with acquired CPR skills to know that they can do foot compressions in situations where they cannot use their hands.
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Multicenter Study
Surviving traumatic cardiac arrest: Identification of factors associated with survival.
The endpoint of resuscitative interventions after traumatic injury resulting in cardiopulmonary arrest varies across institutions and even among providers. The purpose of this study was to examine survival characteristics in patients suffering torso trauma with no recorded vital signs (VS) in the emergency department (ED). ⋯ Over a recent nine-year period in the United States, nearly 25,000 trauma patients were treated at trauma centers despite lack of VS. Of these patients, only 73 were discharged home. A trauma center would have to attempt over one hundred resuscitations of traumatic arrests to save one patient, confirming previous reports that highlight a grave prognosis. This creates a dilemma in treatment for front line workers and physicians with resource utilization and consideration of safety of exposure, particularly in the face of COVID-19.