The American journal of emergency medicine
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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.
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The purpose of this study was to investigate eye injuries resulting from frontal automobile crashes and to determine the effects of depowered airbags. The National Automotive Sampling System database files from 1993 to 2000 were examined in a 3-part investigation of 22 236 individual crashes. ⋯ Occupants were at a significantly higher risk to sustain an airbag-induced eye injury when exposed to a full powered airbag compared with occupants exposed to a depowered airbag deployment ( P = .04). Approximately, 90% of the eye injuries in full powered airbag deployments were caused by the airbag, compared to only 35% of the depowered airbag eye injuries.
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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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Comparative Study
Elevated international normalized ratio in the ED: clinical course and physician adherence to the published recommendations.
Describe the course of patients with an elevated international normalized ratio (INR) in the emergency department (ED) and determine physicians' adherence with treatment recommendations. ⋯ Adherence to the recommendations regarding managing elevated INR was suboptimal. There is a need for formal endorsement of recommendations by emergency medicine organizations and development of disposition criteria based on bleeding status and site of bleeding.
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Comparative Study Clinical Trial
Relationship between arterial oxygen saturation and heart rate variability at high altitudes.
Autonomic nervous systems have important roles for survival of victims under hypobaric hypoxic condition. In the present study, we assessed the correlation between arterial oxygen saturation (Sp O 2 ) and heart rate variability (HRV) to identify the autonomic nervous responsiveness among trekkers at high altitude (n = 21). HRV was analyzed by the maximum entropy method. ⋯ Sp O 2 value among subjects with mountain sickness symptoms was not different from that among subjects without the symptoms. In conclusion, autonomic responses among high-altitude trekkers may be blunted under hypobaric hypoxic conditions. Deterioration of autonomic function measured by HRV might be more sensitive to hypoxia than clinical symptoms at high altitudes.