Annals of emergency medicine
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Randomized Controlled Trial Clinical Trial
Comparison of nasal tampons for the treatment of epistaxis in the emergency department: a randomized controlled trial.
Nasal tampons are commonly used to stop bleeding, yet their insertion is painful. We compare the pain of insertion and removal of 2 commonly used nasal tampons. ⋯ The Rapid Rhino nasal tampon is less painful to insert and easier to remove than the Rhino Rocket, whereas both are similarly effective at stopping nosebleeds.
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Comparative Study
Student drivers: a study of fatal motor vehicle crashes involving 16-year-old drivers.
Motor vehicle crashes are the leading cause of death for US teenagers, accounting for 40% of fatalities. The purpose of this study was to compare novice (aged 16 years) and experienced (aged 25 to 49 years) drivers involved in fatal motor vehicle crashes with respect to crash characteristics and driver behaviors. ⋯ Fatal motor vehicle crashes involving novice drivers are characterized by speeding, recklessness, single-vehicle and rollover crashes, and traffic law violations, suggesting that novice drivers bear considerable responsibility for their fatal crashes. Moreover, almost half of 16-year-old drivers involved in fatal motor vehicle crashes were not wearing their safety belts. These data may prove useful in strengthening graduated licensing laws and in improving drivers' education courses and public safety campaigns.
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There is a high prevalence of unmet substance abuse treatment need among adult hospital emergency department (ED) patients. We examine the association between this unmet need and excess utilization of health services and estimate costs. ⋯ ED patients with unmet substance abuse treatment need generated much higher hospital and ED charges than patients without such need. Given potential savings from avoidable health care costs, the future burden of substance-associated ED visits and hospitalizations may be reduced through programs that screen and, as appropriate, provide brief interventions or treatment options to these patients.
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Pain is subjective. The pain response is individual and is learned through social learning and experience. Early pain experiences may play a particularly important role in shaping an individual's pain responses. ⋯ Inadequate relief of pain and distress during childhood painful medical procedures may have long-term negative effects on future pain tolerance and pain responses. This article reviews the evidence for long-term negative effects of inadequately treated procedural pain, the determinants of an individual's pain response, tools to assess pain in children, and interventions to reduce procedural pain and distress. Future research directions and a model for conceptualizing and studying pediatric procedural pain are proposed.