Annals of emergency medicine
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Multicenter Study
Do children with blunt head trauma and normal cranial computed tomography scan results require hospitalization for neurologic observation?
Children evaluated in the emergency department (ED) with minor blunt head trauma, defined by initial Glasgow Coma Scale (GCS) scores of 14 or 15, are frequently hospitalized despite normal cranial computed tomography (CT) scan results. We seek to identify the frequency of neurologic complications in children with minor blunt head trauma and normal ED CT scan results. ⋯ Children with blunt head trauma and initial ED GCS scores of 14 or 15 and normal cranial CT scan results are at very low risk for subsequent traumatic findings on neuroimaging and extremely low risk of needing neurosurgical intervention. Hospitalization of children with minor head trauma after normal CT scan results for neurologic observation is generally unnecessary.
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Randomized Controlled Trial
The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial.
We determine whether high-flow oxygen reduces the incidence of hypoxia by 20% in adults receiving propofol for emergency department (ED) sedation compared with room air. ⋯ High-flow oxygen reduces the frequency of hypoxia during ED propofol sedation in adults.
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Randomized Controlled Trial
A randomized clinical trial comparing oral, aerosolized intranasal, and aerosolized buccal midazolam.
We determine whether aerosolized intranasal or buccal midazolam reduces the distress of pediatric laceration repair compared with oral midazolam. ⋯ When comparing the administration of midazolam by 3 routes to facilitate pediatric laceration repair, we observed slightly less distress in the aerosolized buccal group. The intranasal route demonstrated a greater proportion of patients with optimal activity scores, greater proportions of parents wanting similar sedation in the future, and faster onset but was also the most poorly tolerated at administration. Aerosolized buccal or intranasal midazolam represents an effective and useful alternative to oral midazolam for sedation for laceration repair.
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Our primary objective is to calculate the relative risk of cardiac arrests at the development guide plan (DGP) (equivalent to census tract) level in a city-state, Singapore, and examine its relationship with key area-level population characteristics. ⋯ The risk of cardiac arrests could be related to the age and racial and family structure of DGPs in Singapore. This article models how such data can help to direct public health education, cardiopulmonary resuscitation training, and public access defibrillation programs in other health systems.