The American journal of emergency medicine
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The diagnostic of primary or secondary headaches in emergency units is mostly based on brain imaging, which is expensive and sometimes hardly accessible. An increase in serum S100B protein has already been found in several neurological conditions inducing brain damage. The objective of this study was to assess the diagnostic performance of S100B serum assay to distinguish primary and secondary headaches among patients with non-traumatic headaches in the emergency department. ⋯ The assay of the S100B protein could be useful in the management of this pathology in emergencies. Future studies taking into account dosing time and etiologies could be conducted in order to refine its use in practice.
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Review Meta Analysis
Advanced airway management for pediatric out-of-hospital cardiac arrest: A systematic review and network meta-analysis.
Although airway management is important in pediatric resuscitation, the effectiveness of bag-mask ventilation (BMV) and advanced airway management (AAM), such as endotracheal intubation (ETI) and supraglottic airway (SGA) devices, for prehospital resuscitation of pediatric out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to determine the efficacy of AAM during prehospital resuscitation of pediatric OHCA cases. ⋯ Although the available evidence is from observational studies and its certainty is low to very low, prehospital AAM for pediatric OHCA did not improve outcomes.
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Randomized Controlled Trial
Could we use the comfort score instead of the numeric rating pain score? A proof of concept pilot study.
Asking patients about pain in the Emergency Department (ED) when deriving a pain score may aggravate perception of pain due to the nocebo-effect. A strategy for diminishing this nocebo-effect is cognitive reframing. Cognitive reframing of the frequently used pain score (PS) in the ED could theoretically be obtained by using the comfort score (CS). The aim of this study was to evaluate whether or not the CS and PS are interchangeable and therefore, whether or not the CS could safely be used in ED patients. ⋯ This proof of concept study suggest interchangeability of the PS and the ICS in patients with pain in the ED. However, while not statistically significant, 33% of the patients had a possible clinical significant difference in score outcome, potentially over- or underestimating the patients pain. Whether or not this can be used as a tool for cognitive reframing to reduce perception of pain and medication consumption has yet to be studied.