Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
Subcutaneous buffered lidocaine for intravenous cannulation: is there a role in emergency medicine?
To prospectively evaluate whether subcutaneous buffered lidocaine (SQBL) significantly reduces the pain or adversely affects the success rate of i.v. cannulation (IVC) in adult ED patients. ⋯ SQBL significantly reduced the pain, while not adversely affecting the success rate, of IVC in adult patients in the ED.
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Randomized Controlled Trial Clinical Trial
Cutaneous tape stripping to accelerate the anesthetic effects of EMLA cream: a randomized, controlled trial.
Most medications are not absorbed topically due to the stratum corneum barrier. While effective as a topical anesthetic, EMLA cream is absorbed slowly, delaying its effects for up to one hour, thereby limiting its usefulness. ⋯ Removal of the cornified layer of the skin resulted in a more rapid anesthetic effect of EMLA cream as evidenced by lower IVC pain scores after TS. The effectiveness of TS for enhanced absorption of other medications should be investigated.
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Comparative Study
A comparison of standardized and narrative letters of recommendation.
To compare the Council of Emergency Medicine Residency Directors' (CORD's) standardized letters of recommendation (SLORs) with traditional narrative letters of recommendation (NLORs) with regard to interrater reliability, consistency, and time of interpretation. ⋯ Compared with NLORs, the CORD SLOR offers better interrater reliability with less interpretation time. Single-author SLOR/NLOR pairs submitted for a single applicant do not correlate well. Residency selection committees must decide whether the added work of interpreting NLORs is beneficial.
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Patient refusal of transport after treatment of hypoglycemia is common in urban emergency medical services (EMS) systems. The rate of relapse is unknown. The goal of this study was to compare the outcomes of diabetic patients initially refusing transport (refusers) and those transported to an ED. ⋯ The out-of-hospital treatment of hypoglycemic diabetic patients appears to be effective and efficient. Independent of the patient's refusal or acceptance of transport, the out-of-hospital treatment of hypoglycemic patients in this system appears to be safe.
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Unintentional falls are the leading cause of injury and the second most common cause of unintentional injury deaths in the United States, and place a great burden on EDs. In this study, the objective was to describe the incidence and characteristics of ED visits associated with unintentional falls in the United States. ⋯ This study reports nationally representative data describing the incidence and characteristics of fall-related ED visits. These data expand what is known about the epidemiology of falls and help to define the burden that fall injuries place on EDs in the United States. The results of this study could serve as a benchmark to evaluate the effectiveness of future fall prevention efforts.