Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2013
Randomized Controlled TrialVaginal examination does not improve diagnostic accuracy in early pregnancy bleeding.
The study aims to determine if a vaginal examination improves diagnostic accuracy when assessing women who present to the ED with vaginal bleeding in the first trimester of pregnancy. ⋯ In a stable patient presenting to the ED with first trimester bleeding, clinical diagnosis is highly inaccurate and is not improved by vaginal examination. Routine vaginal examination is not necessary as part of the initial patient assessment.
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Emerg Med Australas · Oct 2012
Randomized Controlled TrialRandomised trial of magnesium in the treatment of Irukandji syndrome.
Irukandji syndrome is a distressing condition characterised by pain, hypertension and tachycardia. Some develop cardiac failure and there have been two reported deaths. Magnesium sulphate has become the standard of care despite minimal evidence. The aim of this study was to investigate if magnesium would reduce analgesic requirement and length of stay for patients with Irukandji syndrome. ⋯ Our study did not demonstrate a benefit in the use of magnesium in the treatment of Irukandji syndrome. As such the current use of magnesium needs to be reconsidered until there is good evidence to support its use.
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Emerg Med Australas · Jun 2012
Randomized Controlled Trial Comparative StudyAustralian triage tags: a prospective, randomised cross-over trial and evaluation of user preference.
The aim of this study was to determine if any disaster triage tag is superior to others, based on objective parameters (time, accuracy) and subjective parameters (user preference). A secondary aim was to determine the average time to perform triage assessment using 'sieve and sort'. ⋯ The SMART card was preferred by participants based on design issues, which supports its implementation. We suggest that doctors are best used in the casualty clearing post.
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Emerg Med Australas · Apr 2012
Randomized Controlled TrialButylscopolammonium bromide does not provide additional analgesia when combined with morphine and ketorolac for acute renal colic.
To evaluate the effect of adding butylscopolammonium bromide (BB) to morphine and ketorolac in the treatment of acute renal colic in the ED. ⋯ Although the addition of BB to morphine and ketorolac appeared to show a statistically significant reduction in pain compared with morphine and ketorolac alone, a reduction of 1.2 cm on VAS is unlikely to be clinically significant.
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Emerg Med Australas · Feb 2012
Randomized Controlled TrialHow fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial.
For children with croup controversy remains over dosage and time to onset of action of oral steroids. The Cochrane Collaboration and other reviews have suggested 0.6 mg/kg dexamethasone be used (despite some evidence that 0.15 mg/kg is effective) with no expectation of benefit before 4-6 h. This randomized double-blinded clinical trial examines whether 0.15 mg/kg dexamethasone works by 30 min. ⋯ For children with croup an oral dose of 0.15 mg/kg dexamethasone offers benefit by 30 min, much earlier than the 4 h suggested by the Cochrane Collaboration. This result might encourage doctors to treat more children with all severities of croup being less worried about potential side-effects and delayed benefit.