Annals of emergency medicine
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To determine efficacy, safety, recovery times, and parental satisfaction with i.v. ketamine sedation in pediatric patients requiring brief, painful procedures in the emergency department. ⋯ I.v. ketamine is a consistently effective method of producing a rapid, brief period of profound sedation and analgesia in children in the ED. Although no serious complications were noted in our series, larger studies are needed to establish this drug's safety profile in the ED. Vomiting, ataxia, and agitation were noted in a few cases.
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Community-acquired infections and non-AIDS-related illnesses are a significant proportion of the final diagnoses in HIV-infected patients presenting to an emergency department. We hypothesized that emergency physicians over-diagnose opportunistic infections in the HIV-infected patient. We also hypothesized that the absolute CD4 lymphocyte level could be used to stratify patients by likelihood of HIV related disease. ⋯ ED visits by HIV-infected individuals are often not made for reasons of opportunistic infection, and the absolute CD4 lymphocyte count is inversely related to HIV-related disease.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of verapamil-quinidine versus digoxin-quinidine in the emergency department treatment of paroxysmal atrial fibrillation.
To determine the relative effectiveness of a verapamil-quinidine sequential combination versus digoxin-quinidine in the emergency department treatment of paroxysmal atrial fibrillation (PAF). ⋯ The sequential combination of verapamil and quinidine, in the doses studied, is an effective treatment for PAF and is superior to digoxin-quinidine. Digoxin should no longer be considered the treatment of choice for uncomplicated PAF.
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Randomized Controlled Trial Comparative Study Clinical Trial
Emergency management of atrial fibrillation and flutter: intravenous diltiazem versus intravenous digoxin.
To compare the effects of i.v. diltiazem and i.v. digoxin on ventricular rate control in the emergency treatment of acute atrial fibrillation and flutter (AFF). ⋯ Treatment of acute AFF with i.v. diltiazem decreases ventricular heart rate significantly within 5 minutes, compared with 3 hours for treatment with i.v. digoxin. No advantage was noted within 3 hours for i.v. treatment with a combination of diltiazem and digoxin. I.v. diltiazem is superior to i.v. digoxin in the emergency control of ventricular rate in acute AFF and should be considered as a drug of choice for this condition. This study was not large enough to adequately assess adverse effects, and further studies may be warranted for clinical validation.