Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Closed reduction of distal forearm fractures by pediatric emergency physicians.
The objective of this study was to determine if there exist differences in length of stay (LOS) in the emergency department (ED) and need for reintervention to restore alignment after distal forearm fracture reduction by pediatric emergency physicians (EPs) versus postgraduate year 3 or 4 orthopedic residents. ⋯ Length of stay in the ED and clinical outcomes after closed reduction of forearm fractures by trained pediatric EPs are comparable to those after closed reduction by orthopedic residents.
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Although intravenous (IV) magnesium (Mg) can decrease hospitalizations in children with severe acute asthma, its use is often limited to resistant disease, and disposition may be determined prior to its use. Since knowledge about practice patterns of IV Mg would enhance knowledge translation and guide future research, we surveyed pediatric emergency physicians with interest in clinical research to determine the frequency, indications, adverse events, and barriers to use of IV Mg in children with severe acute asthma. ⋯ Intravenous Mg appears to be uncommonly used in stable children with severe acute asthma and does not frequently play a role in reducing hospitalizations. Further research to justify its enhanced use and to better establish its true adverse effect profile is indicated.
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The objective was to evaluate the use of a single 2 μg/kg dose of intranasal fentanyl as analgesia for painful orthopedic injuries in children presenting to a pediatric emergency department (ED). ⋯ Intranasal fentanyl at a dose of 2 μg/kg provides effective analgesia for pediatric ED patients with painful orthopedic trauma within 10 minutes of administration.
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The accurate noninvasive assessment of preload in emergency department (ED) patients remains elusive. Point-of-care ultrasound (US) imaging, particularly evaluation of the inferior vena cava (IVC), has been shown to be qualitatively helpful. Doppler and tissue Doppler are now routinely available on ED US equipment, but few studies have looked at the correlation of dynamic changes in these parameters in a controlled model of hypovolemia. Our objective was to examine the correlation of Doppler parameters to simulated volume loss in healthy subjects using a lower-body negative pressure (LBNP) model and to compare these measurements to commonly used IVC measurements of preload. ⋯ In this pilot study of healthy subjects, tissue Doppler assessment of early diastolic filling correlated most strongly with simulated hypovolemia.
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This experimental study aimed to assess the changes in the levels of serum ischemia-modified albumin (IMA) and interleukin-6 (IL-6) by time in cases of acute mesenteric ischemia due to superior mesenteric artery occlusion. ⋯ IMA may be helpful as a marker in the diagnosis of acute mesenteric ischemia; however, its diagnostic value and use as a routine biochemical test should be assessed in further studies.