European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We reviewed the use of noninvasive ventilation (NIV) versus high flow nasal cannula (HFNC) oxygen in adult acute respiratory failure (ARF). We searched major databases and included randomized trials comparing at least NIV with HFNC or NIV+HFNC with NIV in ARF. Primary outcomes included intubation/re-intubation rates. ⋯ The secondary outcomes included differences in ICU mortality and patient tolerability, favouring HFNC. Results were conflicting, but highlighted future research directions. These include patients with hypercapneic ARF, more severe hypoxaemia (PaO2/FiO2≤200 mmHg), a superiority design, an oxygen arm and patient-centred outcomes.
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A significant proportion of patients with acute stroke symptoms have an alternative 'mimic' diagnosis. A narrative review was carried out to explore the frequency, characteristics and aetiology of stroke mimics. Prehospital and thrombolysis-treated patients were described separately. ⋯ Nineteen per cent of suspected stroke patients had a mimic condition. Stroke mimics were more common with younger age and female sex. The range of mimic diagnoses, a lack of clear differentiating characteristics and the short treatment window for ischaemic stroke create challenges for early identification.
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Randomized Controlled Trial
Lidocaine spray as a local analgesic for intravenous cannulation: a randomized clinical trial.
Lidocaine spray is an effective analgesic of mucous membranes. Lidocaine spray is also used during intravenous (i.v.) cannulation, especially in children. However, the analgesic effect of lidocaine spray during i.v. cannulation has not been studied. We aimed to assess the analgesic effectiveness of lidocaine spray during i.v. cannulation. ⋯ Local administration of lidocaine is not effective in reducing pain during i.v. cannulation.
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Observational Study
Rapid detection of bacterial meningitis using a point-of-care glucometer.
In case of acute bacterial meningitis, a decision on the need for intensive care admission should be made within the first hour. The aim of this study was to assess the ability of a point-of-care glucometer to determine abnormal cerebrospinal fluid (CSF) glucose concentration at the bedside that contributes toward bacterial meningitis diagnosis. ⋯ A glucometer accurately detects an abnormal CSF/blood glucose ratio immediately after the lumbar puncture. This cheap point-of-care method has the potential to speed up the diagnostic process of patients with bacterial meningitis.
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Historical Article
Analysis of the citation of articles published in the European Journal of Emergency Medicine since its foundation.
The aim of this study was to evaluate the evolution of the citation of articles from the European Journal of Emergency Medicine (EJEM) from 1994 (EJEM foundation) to 2015 and identify highly cited articles and their principal characteristics and determine a possible correlation between the citations counted in different databases. ⋯ Citation of EJEM articles has progressively increased and EJEM bibliometric indicators have improved; most highly cited articles are mainly by European authors.