Annals of emergency medicine
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Randomized Controlled Trial Comparative Study
The PICHFORK (Pain in Children Fentanyl or Ketamine) Trial: A Randomized Controlled Trial Comparing Intranasal Ketamine and Fentanyl for the Relief of Moderate to Severe Pain in Children With Limb Injuries.
We compare the analgesic effectiveness of intranasal fentanyl and ketamine in children. ⋯ Intranasal fentanyl and ketamine were associated with similar pain reduction in children with moderate to severe pain from limb injury. Ketamine was associated with more minor adverse events.
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Randomized Controlled Trial Multicenter Study
Efficacy and Safety of Out-of-Hospital Intravenous Metoprolol Administration in Anterior ST-Segment Elevation Acute Myocardial Infarction: Insights From the METOCARD-CNIC Trial.
We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)-administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. ⋯ Out-of-hospital administration of intravenous metoprolol by EMS within 4.5 hours of symptom onset in our subjects reduced infarct size and improved left ventricular ejection fraction with no excess of adverse events during the first 24 hours.
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Randomized Controlled Trial
Randomized Controlled Trial of a Scoring Aid to Improve GCS Scoring by EMS Providers.
Emergency medical services (EMS) personnel frequently use the Glasgow Coma Scale (GCS) to assess injured and critically ill patients. This study assesses the accuracy of EMS providers' GCS scoring, as well as the improvement in GCS score assessment with the use of a scoring aid. ⋯ In this study, 60% of EMS participants provided inaccurate GCS score estimates. Use of a GCS scoring aid improved accuracy of EMS GCS score assessments.