Emergency medicine journal : EMJ
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Randomized Controlled Trial Comparative Study
A randomised, double-blind, placebo-controlled study to evaluate the role of formoterol in the management of acute asthma.
To evaluate the efficacy and tolerability of formoterol delivered by Aerolizer in the emergency department. ⋯ Formoterol was found to be well tolerated and as effective as salbutamol in the management of acute asthma. Further studies are needed to follow the patients after discharge from the emergency room to compare the long-term effect of formoterol on patients' stability.
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Multicenter Study
Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study.
To report our experience monitoring patients with previously identified theoretical risk factors of significant electrical injury. ⋯ Although only patients deemed at risk of late arrhythmias were monitored, none developed potentially lethal late arrhythmias. Asymptomatic patients with transthoracic current and/or tetany and a normal initial ECG do not require cardiac monitoring after an electrical injury with voltage <1000 V and no loss of consciousness.
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To evaluate the performance of a simple screening tool for chest radiography for identification of community-acquired pneumonia (CAP) among emergency department (ED) patients who present with respiratory-related complaints. Our screening tool is a modification of a previously published guideline, which relied only on the presence of vital-sign abnormality (97% sensitivity, 19% specificity). We included respiratory symptoms to improve the specificity, defining our screening tool as the presence of any one respiratory symptom (cough, chest pain or shortness of breath) and any abnormality of the vital signs (temperature >38 degrees C, heart rate >100 beats/min, respiration rate >20 breaths/min, or pulse oximetry <95%). ⋯ A simple screening tool with high sensitivity and specificity was used in an urban inner city ED to decide on the requirement for chest radiographs for patients with respiratory symptoms for identification of CAP. Validation studies are required to determine the utility of this screening tool for improving time to diagnosis and treatment.
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Increase in lactate (LAC) within the central nervous system after head trauma is an established marker of traumatic brain injury (TBI). ⋯ Arterial BD and LAC are poor predictors of TBI in isolated head trauma.
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Case Reports
A cause for concern? Osteopoikilosis found incidentally in the emergency department: a case report.
Osteopoikilosis is a rare, inherited bone disorder, which is usually found incidentally on x ray. It may be mistaken for other, more serious disorders such as bony metastases, causing undue distress to the doctor and patient.