Singap Med J
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Randomized Controlled Trial
Comparison of the effectiveness of intravenous piracetam and intravenous dimenhydrinate in the treatment of acute peripheral vertigo in the emergency department.
We aimed to compare the effectiveness of intravenous piracetam with that of intravenous dimenhydrinate in the treatment of acute peripheral vertigo in the emergency department. ⋯ Dimenhydrinate and piracetam have similar levels of effectiveness with regard to acute vertigo. We conclude that piracetam, which has fewer side effects than dimenhydrinate, better vestibular compensation, and is effective for both acute and chronic vertigo, could be more frequently used in the emergency treatment of acute vertigo.
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Multicenter Study Comparative Study
Can the characteristics of emergency department attendances predict poor hospital outcomes in patients with sepsis?
The emergency department (ED) is often the initial site of identification of patients with sepsis. We aimed to determine the characteristics of ED attendances that predict poor hospital outcomes. ⋯ Mode of arrival and triage score, which are characteristics unique to the ED, may predict poor hospital outcomes in patients with sepsis.
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Randomized Controlled Trial Comparative Study
Evaluation of a novel device that maintains the balance of a cardiopulmonary resuscitation performer in a moving ambulance to improve chest compression quality.
According to the findings of some studies, instability due to inertia during changes in speed may negatively impact the quality of chest compressions performed during cardiopulmonary resuscitation (CPR) in a moving environment. This study thus aimed to introduce a simple device that maintains the balance of a person performing CPR in a moving environment, such as an ambulance. We also sought to evaluate the effectiveness of this device in the improvement of the quality of chest compressions. ⋯ By maintaining the balance of the CPR performer, our proposed novel device can offset the negative impact that instability (due to a moving environment) has on chest compressions. The device may also lead to an increase in the percentage of chest compressions that achieve adequate depth.
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Constipation is a common poststroke complication. This study was designed to document the incidence and clinical course of poststroke constipation in a rehabilitation ward, as well as identify the factors independently associated with the condition. ⋯ Poststroke constipation is a common complication during inpatient rehabilitation. Healthcare providers should be aware of the incidence of poststroke constipation. Further studies are required to establish standard guidelines for screening and managing bowel function in patients with stroke.
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The ilioinguinal-iliohypogastric (IG-IH) nerve block provides effective opioid-sparing analgesia for inguinal surgeries. The technique is especially useful in apnoea-prone premature neonates with sacral anomalies and coagulopathy. A recent retrospective review of 82 ex-premature neonates who underwent inguinal herniotomy at KK Women's and Children's Hospital, Singapore, reported a success rate of 89% for landmark-guided IG-IH blocks. ⋯ There is also a stronger need to ensure success in these patients in order to avoid the use of opioids and reduce the risk of postoperative apnoea. Ultrasonographic guidance has been reported to improve the success of IG-IH blocks in older children to up to 94%. Herein, we report a series of six ex-premature neonates in whom ultrasonography-guided IG-IH blocks were successfully performed using reduced volumes of local anaesthetics (mean volume 0.17 mL/kg) for inguinal herniotomy.