Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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L-carnitine is an essential compound involved in cellular energy production through free fatty acid metabolism. It has been theorized that severe verapamil toxicity "shifts" heart energy production away from free fatty acids and toward other sources, contributing to profound cardiogenic shock. The primary study objective was to determine whether intravenous (IV) L-carnitine affects survival in severe verapamil toxicity. Secondary objectives were to determine the effects on hemodynamic parameters. The authors hypothesized that IV L-carnitine would increase both survival and hemodynamic parameters in severe verapamil toxicity. ⋯ When compared with saline, IV L-carnitine increases survival and MAP in a murine model of severe verapamil toxicity.
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Randomized Controlled Trial
Consensus conference follow-up: inter-rater reliability assessment of the Best Evidence in Emergency Medicine (BEEM) rater scale, a medical literature rating tool for emergency physicians.
Studies published in general and specialty medical journals have the potential to improve emergency medicine (EM) practice, but there can be delayed awareness of this evidence because emergency physicians (EPs) are unlikely to read most of these journals. Also, not all published studies are intended for or ready for clinical practice application. The authors developed "Best Evidence in Emergency Medicine" (BEEM) to ameliorate these problems by searching for, identifying, appraising, and translating potentially practice-changing studies for EPs. An initial step in the BEEM process is the BEEM rater scale, a novel tool for EPs to collectively evaluate the relative clinical relevance of EM-related studies found in more than 120 journals. The BEEM rater process was designed to serve as a clinical relevance filter to identify those studies with the greatest potential to affect EM practice. Therefore, only those studies identified by BEEM raters as having the highest clinical relevance are selected for the subsequent critical appraisal process and, if found methodologically sound, are promoted as the best evidence in EM. ⋯ The BEEM rater scale is a highly reliable, single-question tool for a small number of EPs to collectively rate the relative clinical relevance within the specialty of EM of recently published studies from a variety of medical journals. It compares favorably with the MORE system because it achieves a high IRR despite simply requiring raters to read each article's title and conclusion.
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Short, subjective measures of numeracy and general health literacy in an adult emergency department.
The objective was to evaluate the reliability and validity of brief subjective measures of numeracy and general health literacy in the adult emergency department (ED) setting. ⋯ The SNS and SLS are reliable, valid tests that can be used to rapidly estimate general health literacy and numeracy skill levels in adult ED patients. Continuing work is needed to establish their ability to predict clinical outcomes.