Annals of emergency medicine
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Randomized Controlled Trial
ProTECT: a randomized clinical trial of progesterone for acute traumatic brain injury.
Laboratory evidence indicates that progesterone has potent neuroprotective effects. We conducted a pilot clinical trial to assess the safety and potential benefit of administering progesterone to patients with acute traumatic brain injury. ⋯ In this small study, progesterone caused no discernible harm and showed possible signs of benefit.
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Randomized Controlled Trial Multicenter Study Comparative Study
Tramadol/acetaminophen or hydrocodone/acetaminophen for the treatment of ankle sprain: a randomized, placebo-controlled trial.
This randomized, multicenter study compares the analgesic efficacy and safety of tramadol/acetaminophen versus hydrocodone/acetaminophen versus placebo for the treatment of acute musculoskeletal pain caused by ankle sprain. ⋯ One or 2 capsules of 37.5 mg tramadol/325 mg acetaminophen and 1 capsule of 7.5 mg hydrocodone/650 mg acetaminophen were well tolerated, had comparable clinical utility, and were more effective than placebo in the management of acute musculoskeletal pain caused by ankle sprain.
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Randomized Controlled Trial Comparative Study
Randomized double-blind placebo-controlled trial of two intravenous morphine dosages (0.10 mg/kg and 0.15 mg/kg) in emergency department patients with moderate to severe acute pain.
We compare pain relief and safety of morphine 0.10 mg/kg with 0.15 mg/kg in adult emergency department (ED) patients with acute pain. ⋯ Although 0.15 mg/kg of morphine is safe and provides statistically superior analgesia compared with a dose of morphine at 0.10 mg/kg, this difference in pain reduction did not reach the threshold of greater than 1.3 numeric rating scale units required to declare the higher dose of morphine clinically superior.
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We externally validate the ability of the San Francisco Syncope Rule to accurately identify syncope patients who will experience a 7-day serious clinical event. ⋯ In this external validation cohort, the San Francisco Syncope Rule had a lower sensitivity and specificity than in previous reports.
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Medical simulation allows trainees to experience realistic patient situations without exposing patients to the risks inherent in trainee learning and is adaptable to situations involving widely varying clinical content. Although medical simulation is becoming more widely used in medical education, it is typically used as a complement to existing educational strategies. ⋯ We applied adult learning principles, medical simulation learning theory, and standardized national curriculum requirements to create an innovative set of simulation-based modules for integration into our emergency medicine residency curriculum. Here we describe the development of our simulation modules using various simulation technologies, their implementation, and our experiences during the first year of integration.