Annals of emergency medicine
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Randomized Controlled Trial Comparative Study
A randomized clinical trial of ibuprofen versus acetaminophen with codeine for acute pediatric arm fracture pain.
We compare the treatment of pain in children with arm fractures by ibuprofen 10 mg/kg versus acetaminophen with codeine 1 mg/kg/dose (codeine component). ⋯ Ibuprofen was at least as effective as acetaminophen with codeine for outpatient analgesia for children with arm fractures. There was no significant difference in analgesic failure or pain scores, but children receiving ibuprofen had better functional outcomes. Children receiving ibuprofen had significantly fewer adverse effects, and both children and parents were more satisfied with ibuprofen. Ibuprofen is preferable to acetaminophen with codeine for outpatient treatment of children with uncomplicated arm fractures.
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Randomized Controlled Trial
Randomized clinical trial comparing a patient-driven titration protocol of intravenous hydromorphone with traditional physician-driven management of emergency department patients with acute severe pain.
We test the null hypothesis that the "1+1" hydromorphone patient-driven protocol is clinically and statistically equivalent in safety and efficacy to that of traditional physician-driven administration of opioids for emergency department (ED) treatment of acute severe pain. ⋯ The 1+1 hydromorphone patient-driven protocol is statistically superior and at least as clinically efficacious and safe as traditional physician-driven treatment of ED patients with acute severe pain. More than 9 of 10 patients randomized to the study protocol achieved satisfactory pain control, as defined by the patient, within an hour or less.
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Randomized Controlled Trial
Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial.
This randomized, placebo-controlled trial evaluates the analgesic efficacy and safety of intravenous single-dose paracetamol and morphine for the treatment of renal colic. ⋯ Intravenous paracetamol is an efficacious and safe treatment for ED patients with renal colic.
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Randomized Controlled Trial
Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.
The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. ⋯ The results of this study suggest that of the stabilization procedures completed by emergency physicians, dentists preferred the bondable reinforcement ribbon for managing an avulsed tooth and the light-cured composite technique for managing a fractured tooth over the commonly taught and more frequently used procedures in emergency medicine.