The American journal of emergency medicine
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Comparative Study
Comparison of efficacy nebulized fentanyl with intravenous ketorolac for renal colic in patients over 12 years old.
Acute renal colic is one of the common causes of referral to the hospitals. The aim of this study is to compare the efficacy of nebulized fentanyl with that of intravenous ketorolac in renal colic patients. ⋯ Intravenous ketorolac had better analgesic effects in renal colic patients compared with nebulized fentanyl. Further studies that include complications and combinational therapy are required.
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Many victims of drowning fatalities are lay-people attempting to rescue another. This review aims to identify the safest techniques and equipment (improved or purpose made) for an untrained bystander to use when attempting a water rescue. ⋯ The expert recommendation of the safest technique for a lay-rescuer is to attempt rescue using a pole, rope, or flotation equipment without entering the water. However, despite the recommendations of non-contact rescues from land, there is a global tendency to attempt contact rescues in the water, despite a lack of evidence on which technique, procedure or equipment contributes to a safer rescue. Training strategies for lay-people should be considered.
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Intravenous (IV) Lidocaine can be used as analgesic in acute pain management in the emergency department (ED). ⋯ The findings of this study suggest that IV lidocaine can be a good choice in pain management in biliary colic and can reduce pain in less time than morphine sulfate (in 10 min) without adding significant side effects; however, our primary outcome was the comparison of these two drugs after 60 min of drug administration in pain reduction which showed no significant difference between two groups.
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Comparative Study
Front-loaded diazepam versus lorazepam for treatment of alcohol withdrawal agitated delirium.
Front-loaded diazepam is used to rapidly control agitation in patients with severe alcohol withdrawal syndrome (AWS). Our institution began using front-loaded lorazepam in August 2017 secondary to a nation-wide shortage of intravenous (IV) diazepam. Currently, there are no studies comparing lorazepam to diazepam for frontloading in severe AWS. ⋯ Front-loaded lorazepam was similar to front-loaded diazepam in controlling AWS symptoms. Lorazepam's delayed onset of action should be considered when determining how quickly repeat doses are administered to avoid the potential for adverse drug events.
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Comparative Study
Comparing neighborhood-based indices of socioeconomic risk factors and potentially preventable emergency department utilization.
Neighborhood stress score (NSS) and area deprivation index (ADI) are two neighborhood-based composite measures used to quantify an individual's socioeconomic risk based on home location. In this analysis, we compare the relationships between an individual's socioeconomic risk, based on each of these measures, and potentially preventable acute care utilization. ⋯ ADI and NSS both represent effective tools to assess the potential impact of geographically-linked socioeconomic drivers of health on potentially preventable acute care utilization. NSS decile was associated with a greater effect size for each measure of utilization suggesting that this may be a stronger predictor, however, additional research is necessary to evaluate these findings in other contexts.