Annals of emergency medicine
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Randomized Controlled Trial Clinical Trial
Intramuscular ketorolac versus oral ibuprofen in acute musculoskeletal pain.
To evaluate the efficacy of IM ketorolac versus that of oral ibuprofen in acute musculoskeletal pain. ⋯ IM ketorolac and oral ibuprofen provide comparable analgesia in ED patients with acute musculoskeletal pain.
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Randomized Controlled Trial Clinical Trial
Comparison of plain, warmed, and buffered lidocaine for anesthesia of traumatic wounds.
To compare pain on infiltration, need for additional anesthesia, and pain on suturing in patients given plain, warm, and buffered lidocaine preparations before the suturing of traumatic wounds in the emergency department. ⋯ Both buffered and warmed lidocaine were as efficacious as plain lidocaine, and they had significantly less pain associated with infiltration than did plain lidocaine. In EDs with fluid warmers, warmed lidocaine may be the most convenient, well-tolerated, efficacious lidocaine preparation for anesthesia of traumatic wounds.
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Epinephrine has been used in cardiac arrest to increase the low blood flow generated by standard CPR methods. Reperfusion with high flow such as that obtained with cardiopulmonary bypass (CPB) may obviate the need for or alter the dose of epinephrine after cardiac arrest. The objective of this study was to evaluate the effect of high-flow reperfusion after cardiac arrest with and without epinephrine on coronary perfusion pressure, defibrillation energy, restoration of spontaneous circulation (ROSC), and 2-hour survival after prolonged cardiac arrest. ⋯ Restoration of high blood flow alone is insufficient to restore spontaneous circulation after prolonged cardiac arrest. Epinephrine, when administered early under high-flow conditions, increases coronary perfusion pressure, decreases defibrillation energy, and decreases time elapsed before ROSC. Higher doses of epinephrine under conditions of high-flow reperfusion do not improve 2-hour survival compared with standard-dose epinephrine.
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To evaluate the usefulness of the prehospital index (PHI) as a triage tool in a population of trauma patients. ⋯ PHI of 4 or more had limitations as a screening tool for triage in our study population because of the high number of patients it categorized as having minor trauma who required emergency surgery.
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To compare the overall satisfaction with emergency department care of patients seen by a nurse practitioner (NP) with that of patients seen in the usual fashion. ⋯ This study supports data from earlier studies suggesting that patients are satisfied with ambulatory care delivered by NPs.