The American journal of emergency medicine
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Patients who present with atrial fibrillation (AF) or flutter with rapid ventricular response (RVR) and hemodynamic stability may be managed with either an intravenous (IV) nondihydropyridine calcium channel blocker (CCB) or a beta-blocker (BB). Patients without improved heart rates may need to switch to, or add, a second AV nodal blocker. ⋯ Adding a second nodal blocker in patients who did not achieve rate control with the first agent resulted in heart rate control 46% of the time. The development of symptomatic bradycardia was uncommon.
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Multicenter Study Comparative Study
Time to antibiotic administration: Sepsis alerts called in emergency department versus in the field via emergency medical services.
The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) identifies patients with "severe sepsis" and mandates antibiotics within a specific time window. Rapid time to administration of antibiotics may improve patient outcomes. The goal of this investigation was to compare time to antibiotic administration when sepsis alerts are called in the emergency department (ED) with those called in the field by emergency medical services (EMS). ⋯ Sepsis alerts called in the field via EMS may decrease time to antibiotics and increase the likelihood of antibiotic administration occurring within 60 min of arrival when compared to those called in the ED.
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Meta Analysis
Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis.
In this systematic review and meta-analysis, we aimed to explore the association between cardiac injury and mortality, the need for intensive care unit (ICU) care, acute respiratory distress syndrome (ARDS), and severe coronavirus disease 2019 (COVID-19) in patients with COVID-19 pneumonia. ⋯ Cardiac injury is associated with mortality, need for ICU care, and severity of disease in patients with COVID-19.
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Randomized Controlled Trial
Intradermal sterile water injection versus diclofenac sodium in acute renal colic pain: A randomized controlled trial.
We aimed to evaluate the efficacy of intracutaneous sterile water injection (ISWI) to relieve the pain of acute renal colic compared with diclofenac and placebo. ⋯ ISWI and diclofenac were equally effective for the pain relief of acute renal colic.
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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.