Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Comparative Study
Beneficial effects of albuterol therapy driven by heliox versus by oxygen in severe asthma exacerbation.
To determine and define the beneficial effects of heliox-driven albuterol therapy on severe asthma exacerbation and clinical factors that affect greater response. ⋯ Heliox-driven albuterol may be a useful adjunct therapy for older asthmatic patients with severe asthma exacerbation.
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Randomized Controlled Trial Comparative Study
Human patient simulation is effective for teaching paramedic students endotracheal intubation.
The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR). ⋯ When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI.
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Comparative Study
The accuracy and completeness of data collected by prospective and retrospective methods.
To describe and test a model that compares the accuracy of data gathered prospectively versus retrospectively among adult emergency department patients admitted with chest pain. ⋯ Information obtained retrospectively from the abstraction of medical records is measurably less accurate than information obtained prospectively from research subjects. For certain items, more than half of the information is not available. This loss of information is related to the data types included in the study and by the assumptions that a researcher performing a retrospective study makes about implied versus explicitly stated responses. A model of information flow that incorporates the concepts of reliability and validity can be used to measure some of the loss of information that occurs at each step along the way from subject to clinician to medical record abstractor.
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Randomized Controlled Trial
Laser-assisted anesthesia prior to intravenous cannulation in volunteers: a randomized, controlled trial.
Intravenous cannulation is common and painful. Absorption of topical anesthetics is limited by the stratum corneum, the outermost layer of the epidermis. A single pulse of an erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation can remove an area of the stratum corneum, leading to enhanced uptake of topical agents, such as lidocaine, while leaving the rest of the epidermis intact. ⋯ Pretreatment of the skin with a laser device followed by a 5-minute topical lidocaine application reduces the pain of IV cannulation in volunteers.
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There has been little systematic study of emergency department (ED) patients with elevated blood pressure (BP) values. The authors sought to characterize ED patients with elevated BP values, assess presenting symptoms, and determine the prevalence of elevated BP after discharge. ⋯ Elevated BP is common among ED patients. African American patients are more likely than those of other ethnic groups to have greater BP values. The ED visit may be a good opportunity to identify patients with unrecognized or poorly controlled hypertension.