Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Superiority of ipratropium plus albuterol over albuterol alone in the emergency department management of adult asthma: a randomized clinical trial.
The use of nebulized ipratropium in combination with beta-agonists for the treatment of acute asthma in adults is controversial. We wished to test the hypothesis that combined aerosol treatment results in a greater rate of airflow improvement and a lower proportion of hospital admission in adults with acute asthma. ⋯ These data suggest that ipratropium should be combined with initial albuterol nebulization in the ED treatment of acute asthma in adults, especially those with PEFRs less than 200 L/min.
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The 1994 basic-EMT (EMT-B) curriculum recommended teaching EMT-Bs the skill of endotracheal intubation. In this study we assessed the success and complication rates of endotracheal intubations in the field by EMT-Bs. ⋯ EMT-Bs trained in a short course successfully intubated about half the patients they encountered in this study. This low intubation success rate calls into question the validity of the endotracheal-intubation training module in the 1994 EMT-B national curriculum. [Sayre MR, Sakles JC, Mistler AF, Evans JL, Kramer AT, Pancioli AM: Field trial of endotracheal intubation by basic EMTs. Ann Emerg Med February 1998;31:228-233.].
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Comparative Study
Interrater reliability of cervical spine injury criteria in patients with blunt trauma.
To determine the interrater reliability of previously defined risk criteria for cervical spine injury. ⋯ The combined cervical spine injury criteria have substantial interrater reliability. Individual criteria are slightly less reliable.
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Comparative Study
Emergency department hypertension and regression to the mean.
To evaluate the importance of regression to the mean in the assessment of asymptomatic hypertension in the emergency department. ⋯ Patients who present with asymptomatic hypertension in the ED on average experience a spontaneous decline in blood pressure after they arrive. Most of this effect can be explained by regression to the mean. A small amount of this drop may represent attenuation of an initial alerting reaction.