Annals of emergency medicine
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To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the ED length of stay and procedures performed in medical critical care patients. ⋯ Critically ill patients spend a substantial amount of time in the ED before transfer to the ICU. Typical ICU procedures are commonly performed. Further study of the impact on patient outcome of ED stay and the procedures performed in critically ill medical patients should be conducted.
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Meta Analysis
Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials.
To determine whether prophylactic antibiotics prevent infection in patients with dog bite wounds. ⋯ Prophylactic antibiotics reduce the incidence of infection in patients with dog bite wounds. The full costs and benefits of antibiotics in this situation are not known. It may be reasonable to limit prophylactic antibiotics to patients with wounds that are at high risk for infection.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Intravenous access in the critically ill trauma patient: a multicentered, prospective, randomized trial of saphenous cutdown and percutaneous femoral access.
To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. ⋯ Percutaneous femoral catheterization can be performed more rapidly than saphenous cutdown in the critically ill trauma patient with a palpable femoral pulse and allows for more rapid fluid administration. We support the use of a percutaneous femoral line as an acceptable alternative to saphenous venous cutdown in the initial resuscitation of trauma patients.
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Randomized Controlled Trial Clinical Trial
Reducing the pain of local anesthetic infiltration: warming and buffering have a synergistic effect.
To compare room-temperature unbuffered lidocaine, warm lidocaine, buffered lidocaine, and warm buffered lidocaine to determine which of the four solutions is least painful during infiltration. ⋯ Skin infiltration with warm buffered lidocaine is significantly less painful than infiltration with room-temperature unbuffered lidocaine, warm lidocaine, or buffered lidocaine.
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A number of studies have shown that expired CO2 concentration is closely related to cardiac output, but that cardiac output was not controlled as an independent variable. In addition, the partial pressure of end-tidal CO2 (PETCO2) during extremely low cardiac output has not been reported. The objective of the present study was to measure PETCO2 during well-controlled, very low blood flow rates under conditions of constant minute ventilation. ⋯ Under conditions of constant minute ventilation, PETCO2 correlated closely with cardiac index over a large range of blood flow rates, including extremely low rates.