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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Comparative Study
Radiologists' review of radiographs interpreted confidently by emergency physicians infrequently leads to changes in patient management.
To determine whether radiologists' review of radiographs is unwarranted when emergency physicians are confident in their interpretations. ⋯ Of 9,599 sets of radiographs interpreted confidently by the emergency physicians in this study, there were 11 clinically significant discordant interpretations (0.1%). The standard practice of radiologists' review of all ED radiographs may not be justifiable.
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The long-term goals of developing research within the specialty of emergency medicine include the following: (1) to continue to improve the quality and quantity of emergency patient care; (2) to maximize the research potential of emergency health care professionals to develop new emergency research talent and enthusiasm; and (3) to establish the academic research credentials of the specialty of emergency medicine to become competitive for federal research funding, and further improve emergency patient care. This article addresses the process by which the infrastructure for emergency medicine research can be developed at academic medical centers and provides recommendations. The roles of the academic chair, research director, senior researcher, and departmental faculty are discussed.
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[Runge JW: NHTSA Notes commentary: Cell phones and the multi-tasking driver. Ann Emerg Med February 1998;31:279-280.].
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Letter Case Reports
Pneumatosis cystoides intestinalis and portal venous air.