Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study Clinical Trial Controlled Clinical Trial
Subcutaneous lidocaine does not affect the success rate of intravenous access in children less than 24 months of age.
To determine whether subcutaneous lidocaine (SQL), when used to decrease the pain of IV catheter insertion, adversely affects IV access in children < 24 months of age. ⋯ SQL use prior to an IV attempt in children < 2 years of age does not impact vascular access. A secondary finding was that vascular access with and without SQL in infants and small children generally can be accomplished in 1 attempt.
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Multicenter Study
A multisite survey of factors contributing to medically unnecessary ambulance transports.
To determine the social and demographic factors associated with medically unnecessary ambulance utilization, and to determine the willingness of patients to use alternate modes of transportation to the ED. ⋯ Patient age < 40 years and Medicaid coverage were associated with medically unnecessary ambulance use. Those patients for whom ambulance use was considered medically unnecessary commonly had no alternate means of transportation. Providing alternate means of unscheduled transportation may reduce the incidence of unnecessary ambulance use.
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To determine the accuracy of CT of the chest in diagnosing the presence of cardiac injury in stable patients with penetrating chest injuries. ⋯ Chest CT may be a useful test for diagnosing the presence of hemopericardium in the setting of penetrating thoracic injury. With the caveat that the patient must be removed from a closely monitored environment, the authors the use of CT in stable patients with penetrating chest wounds whenever echocardiography is unavailable.
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To determine whether the shock index (SI), defined as the ratio of heart rate (HR) to systolic blood pressure (SBP), is a useful marker for significant injury in trauma patients. ⋯ The optimal SI threshold performed similarly to the optimal threshold HR or SBP for prediction of injury severity.
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Randomized Controlled Trial Clinical Trial
Topical tetracaine attenuates the pain of infiltration of buffered lidocaine.
To determine whether topical tetracaine attenuates the pain of buffered lidocaine infiltration. ⋯ Topical tetracaine attenuates the pain of infiltration of buffered lidocaine.