Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
The efficacy of nebulized racemic epinephrine in children with acute asthma: a randomized, double-blind trial.
Recent work in bronchiolitis has demonstrated a significant clinical improvement in children treated with epinephrine over nebulized salbutamol. The objective of this study was to determine whether nebulized epinephrine, as compared with nebulized salbutamol, causes a greater clinical improvement in children with acute asthma. ⋯ There is no significant clinical benefit of nebulized epinephrine over salbutamol in children 1-17 years old with mild to moderate acute asthma. Salbutamol remains the treatment of choice in children with known asthma.
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To evaluate the efficacy of demonstrating pericardial effusion and tamponade using real-time ultrasound. ⋯ We conclude that the porcine model is an adequate model to demonstrate pericardial effusion using real-time ultrasound.
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Clinical Trial
Early discharge of patients with presumed opioid overdose: development of a clinical prediction rule.
To develop a clinical prediction rule to identify patients who can be safely discharged one hour after the administration of naloxone for presumed opioid overdose. ⋯ This prediction rule for safe early discharge of patients with presumed opioid overdose performs well in this derivation set but requires validation followed by confirmation of safe implementation.
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Comparative Study Clinical Trial
Can clinical parameters predict fractures in acute pediatric wrist injuries?
Fractures around the wrist are common in pediatric patients presenting to the emergency department (ED). This pilot study was aimed at identifying clinical variables that are most likely to be associated with a fracture. ⋯ Distal radius point tenderness and a 20% or more decrease in grip strength were predictive of fractures.
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To determine the prevalence and assess documentation by emergency department (ED) physicians (EPs) of impaired mental status in elderly ED patients. ⋯ Impairment in mental status is highly prevalent among older ED patients. Lack of documentation and referrals by EPs suggests lack of recognition of these problems. Further education of physicians is needed to improve care in these areas.