Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized clinical trial of oral versus intramuscular delivery of steroids in acute exudative pharyngitis.
Previous study has shown that the use of intramuscular (IM) steroid leads to improved symptoms in patients with group A beta-hemolytic streptococcus (GABHS). ⋯ The results of this clinical trial suggest that oral steroid and IM steroid provide similar levels of pain relief in acute exudative pharyngitis.
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The assessment of pre-procedure fasting and control of sedation depth are prominent elements of widely disseminated procedural sedation guidelines and of the Joint Commission on Accreditation of Healthcare Organizations' standards. Both exist primarily to minimize the risk of pulmonary aspiration of gastric contents. This paper critically examines the literature on pre-procedure fasting and controlling sedation depth in association with pulmonary aspiration, and interprets this evidence in the context of modern emergency medicine practice. ⋯ It is noted that aspiration during ED PSA has not been reported in the medical literature and that aspiration during general anesthesia and labor and delivery is uncommon. The literature provides no compelling evidence to support specific fasting periods for either liquids or solids prior to PSA, and existing guidelines for elective patients are of necessity arbitrary and based upon consensus opinion. The article discusses the implications in the areas of training and preparedness, monitoring, and research for the emergency physician practicing PSA.
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Comparative Study Clinical Trial
Tissue harmonic imaging improves organ visualization in trauma ultrasound when compared with standard ultrasound mode.
The focused abdominal sonography for trauma (FAST) examination is complicated by brightly lit trauma bays, limited time, and body habitus. Recently, new ultrasound (US) technology has become available that improves organ visualization in abdominal scans. ⋯ Tissue harmonics produced FAST images higher in detail, resolution, and total image quality than standard-mode US images.
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Comparative Study
Parental use and misuse of antibiotics: are there differences in urban vs. suburban settings?
To compare the frequencies with which suburban and urban parents give their children antibiotics without first consulting a physician. ⋯ Parents in the suburban setting were more likely to have misused antibiotics for their children. On the other hand, parents in the urban setting were more likely to have been discharged by a physician at one health facility and gone to another physician's office or ED in order to obtain antibiotics for their children.
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Patient satisfaction has been associated with patient perceptions of emergency department (ED) wait intervals, but not necessarily actual wait intervals. The objective was to address the associations of actual versus perceived wait intervals in ED patients and the association of overall satisfaction with perceived and actual wait intervals. ⋯ Efforts to improve ED patient satisfaction should focus on improving patients' perceptions that wait intervals are appropriate rather than simply shortening wait intervals per se.