Annals of emergency medicine
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Multicenter Study Comparative Study
Effect of a patient's sex on the timing of thrombolytic therapy.
We sought to determine whether a patient's sex independently influences the interval from emergency department arrival to the initiation of thrombolytic therapy in acute myocardial infarction (AMI). ⋯ We infer that a patient's sex may play a significant role in the observed delay in treatment for women. Our data, coupled with previously published work, strongly suggest a systematic negative effect for women in their interaction with the health care system during AMI. We suggest that variables other than systems issues affect the time elapsed before thrombolytic therapy.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Subcutaneous sumatriptan for treatment of acute migraine in patients admitted to the emergency department: a multicenter study.
To assess the efficacy of SC sumatriptan injection versus placebo in the treatment of acute migraine in ED patients and that of open-label 100 mg sumatriptan PO tablets for recurrent migraine. ⋯ Sumatriptan (6 mg SC) is effective in treating acute migraine in the ED. Oral sumatriptan (100 mg) is effective in treating headache recurrence within 24 hours.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Intravenous access in the critically ill trauma patient: a multicentered, prospective, randomized trial of saphenous cutdown and percutaneous femoral access.
To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. ⋯ Percutaneous femoral catheterization can be performed more rapidly than saphenous cutdown in the critically ill trauma patient with a palpable femoral pulse and allows for more rapid fluid administration. We support the use of a percutaneous femoral line as an acceptable alternative to saphenous venous cutdown in the initial resuscitation of trauma patients.
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To determine the incidence of blunt trauma in northern New York City before and after the distribution of 25,000 baseball bats at Yankee Stadium. ⋯ The distribution of 25,000 wooden baseball bats to attendees at Yankee Stadium did not increase the incidence of bat-related trauma in the Bronx and northern Manhattan. There was a positive correlation between daily temperature and the incidence of bat injury. The informal but common impressions of emergency clinicians about the cause-and-effect relationship between Bat Day and bat trauma were unfounded.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A clinical trial of escalating doses of flumazenil for reversal of suspected benzodiazepine overdose in the emergency department.
To determine if flumazenil, when used in doses higher than those currently recommended, could reverse the effects of a benzodiazepine (BDZ) overdose in patients who might not otherwise respond and whether the higher dose was associated with increased adverse effects. ⋯ Flumazenil rapidly and effectively reverses the clinical signs and symptoms of a BDZ overdose. Most patients will respond to 3 mg or less, but a small number may require a higher dose for reversal of clinical symptoms. Patients with concomitant tricyclic antidepressant overdose may be at risk for developing seizures.