The American journal of emergency medicine
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To evaluate the validity of change in visual analog Scale (VAS) as a measure of pain relief using a verbal descriptor Scale (VDS) of change in pain. ⋯ Change in VAS is moderately correlated with a VDS of change in pain. Wide variability in change in VAS and discordance with a VDS demonstrate that change in VAS is not a valid indicator of pain relief for individual patients.
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Dental examination is very important in any patient presenting with craniofacial trauma. Avulsed teeth must be accounted for as they can be found in distant anatomical sites with potential life-threatening complications.
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Pneumopericardium is the presence of air in the pericardial space. In adults, it may be seen in the context with severe blunt chest trauma, pneumothorax, pneumoperitoneum, or other causes of pneumomediastinum. The diagnosis is made by computed tomography scan of the thorax and abdomen that allows the additional detection of concomitant injuries. ⋯ Usually, pneumopericardium is self-limiting requiring no specific therapy. However, a continuous monitoring of the electrocardiography and the blood pressure is necessary at an intermediate care unit. Tension pneumopericardium causing a life-threatening cardiac tamponade requires an immediate pericardial aspiration, the subsequent pericardial drainage via a pericardial window or emergent open subxyphoid approach to the pericardium.
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Comment Letter Case Reports
Ruptured interstitial pregnancy caused by inactive chorionic villi presenting with negative serum beta-hCG.
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Randomized Controlled Trial Clinical Trial
Low-dose naloxone does not improve morphine-induced nausea, vomiting, or pruritus.
We tested the hypothesis that low-dose naloxone delivered with intravenous (IV) bolus morphine to emergency department patients in pain would reduce nausea. ⋯ Addition of 0.25 microg/kg naloxone to bolus morphine does not improve nausea, pruritus, vomiting, or reduce use of rescue antiemetics when administered to emergency department patients in pain.