Emergency medicine journal : EMJ
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Review Meta Analysis
Outcomes of beta blocker use in cocaine-associated chest pain: a meta-analysis.
Beta blockers (β-blockers) remain a standard therapy in the early treatment of acute coronary syndromes. However, β-blocker therapy in patients with cocaine-associated chest pain (CACP) continues to be an area of debate due to the potential risk of unopposed α-adrenergic stimulation and coronary vasospasm. Therefore, we performed a systematic review and meta-analysis of available studies to compare outcomes of β-blocker versus no β-blocker use among patients with CACP. ⋯ In patients presenting with acute chest pain and underlying cocaine, β-blocker use does not appear to be associated with an increased risk of MI or all-cause mortality.
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An 89-year-old female patient presented to the ED with mild abdominal pain and a history of vomiting for 3 days. Because of dementia, further history was unclear. Vital signs were normal. ⋯ There was no episode of vomiting during the ED consultation. A supine AXR was performed (figure 1).emermed;35/9/576/F1F1F1Figure 1Supine AXR. WHAT IS THE DIAGNOSIS?: Foreign bodyGallstone ileusColon obstructionIntestinal volvulus.
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Observational Study
An observational study of patients' attitudes to tattoos and piercings on their physicians: the ART study.
Perceptions regarding body art change over time as societal norms change. Previous research regarding patients' perceptions of physicians with exposed body art have been hampered by flaws in design methodology that incorporate biases into patient responses. This study was performed to determine whether emergency department (ED) patients perceived a difference in physician competence, professionalism, caring, approachability, trustworthiness and reliability in the setting of exposed body art. ⋯ In the clinical setting, having exposed body art does not significantly change patients' perception of the physician.
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Warming intravenous fluids is essential to prevent hypothermia in patients with trauma, especially when large volumes are administered. Prehospital and transport settings require fluid warmers to be small, energy efficient and independent of external power supply. We compared the warming properties and resistance to flow of currently available battery-operated fluid warmers. ⋯ We found significant differences between the fluid warmers: the use of the Buddy Lite should be limited to moderate input temperature and low flow rates. The use of the Thermal Angel is limited to low volumes due to battery capacity and low output temperature at extreme conditions. The Warrior provides the best warming performance at high infusion rates, as well as low input temperatures, and was able to warm the largest volumes in these conditions.