The American journal of emergency medicine
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The objective of this study was to determine the frequency and types of pain medications taken before ED arrival based on pain intensity, duration of pain, chief complaint, gender, age, and race. A convenience sample of patients in pain was enrolled in this university hospital-based prospective, observational study. A total of 1233 patients were enrolled. ⋯ Race and gender were not associated (chi-squared P >.05) with differences in medication use before arrival. Many patients (44%) take medication before arrival in the ED. Age, severity and duration of pain, as well as chief complaint are associated with differences in frequency of self-administered medication.
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Our objective was to assess efficacy and tolerance of thrombolysis using 0.6 mg/kg of Alteplase in patients with massive pulmonary embolism defined as the association of a pulmonary embolism with shock. We retrospectively included 21 patients presenting with a massive pulmonary embolism confirmed by either scintigraphy or spiral computed tomography. Patients were treated on the basis of a standard rationale followed by thrombolysis with 0.6 mg/kg Alteplase over a period of 15 minutes. ⋯ Systolic and diastolic blood pressure (Sp02) were significantly improved 2 hours after the beginning of thrombolysis. Five minor hemorrhagic events occurred. This study demonstrates that for patients with pulmonary embolism and shock, a bolus treatment with Alteplase is potentially effective and well tolerated.
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To determine the significance of routine serum magnesium determination in the ED, a retrospective analysis was done on 253 patients in whom serum magnesium levels were examined in the department of EM. Mild, moderate, and severe hypomagnesemia was found in 19.5%, 9.1%, and 2.5% of the study population, respectively. ⋯ The number of patients admitted to the hospital and the number of patients who died was not statistically significantly different between the groups of patients with normal serum magnesium levels as compared with those with low serum magnesium levels. Although hypomagnesemia was found in 31% of the study population, its clinical significance is not clear given the absence of hypomagnesemia-related complications and death.