Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine whether alkalinization with sodium bicarbonate (NaHCO3) in near-lethal hyperkalemia either lowers potassium (K) rapidly or shortens duration of cardiac conduction disturbances. ⋯ Hypertonic saline bolus lowered plasma K as effectively as NaHCO3 bolus in this animal model within the first 30 minutes. Clinically meaningful decreases due to alkalinization alone within 30 minutes are unlikely.
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Randomized Controlled Trial Clinical Trial
Evaluation of ketorolac in children with forearm fractures.
To evaluate ketorolac for pain relief and an opioid-sparing effect in children with forearm fractures necessitating reduction. ⋯ Although ketorolac seems to add to patient comfort in children with forearm fractures, it does not have a significant opioid-sparing effect. Ketorolac showed a trend toward pain relief, but statistical significance was not reached.
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Comparative Study
Early diagnostic efficiency of cardiac troponin I and Troponin T for acute myocardial infarction.
To compare the early diagnostic efficiency of the cardiac troponin I (cTn-I) level with that of the cardiac troponin T (cTn-T) level, as well as the creatine kinase (CK), CK-MB, and myoglobin levels, for acute myocardial infarction (AMI) in patients without an initially diagnostic ECG presenting to the ED within 24 hours of the onset of their symptoms. ⋯ cTn-I, CK-MB, and myoglobin are significantly more specific for AMI than are CK and cTn-T. Myoglobin is the biochemical marker having the highest combination of sensitivity, specificity, and negative predictive value for AMI within 2 hours of ED presentation. Neither cTn-I nor cTn-T offers significant advantages over myoglobin and CK-MB in the early (< or = 2 hours) initial screening for AMI. The cardiac troponins are of benefit in identifying AMI > or = 6 hours after presentation.