The American journal of emergency medicine
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Randomized Controlled Trial
Decision support system in prehospital care: a randomized controlled simulation study.
Prehospital emergency medicine is a challenging discipline characterized by a high level of acuity, a lack of clinical information and a wide range of clinical conditions. These factors contribute to the fact that prehospital emergency medicine is a high-risk discipline in terms of medical errors. Prehospital use of Computerized Decision Support System (CDSS) may be a way to increase patient safety but very few studies evaluate the effect in prehospital care. The aim of the present study is to evaluate a CDSS. ⋯ The results indicate that this CDSS increases the ambulance nurses' compliance with regional prehospital guidelines but at the expense of an increase in OST.
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Randomized Controlled Trial Comparative Study
Comparison of ketamine-low-dose midozolam with midazolam-fentanyl for orthopedic emergencies: a double-blind randomized trial.
Most of the fractures and dislocations are reduced in the emergency setting. Many drugs are available for procedural sedation and analgesia in the emergency department (ED); however, the adverse effects are still a common problem. The aim of our study was to compare the 2 drug combinations. ⋯ Both drug combinations can be effectively used for procedural sedation and analgesia; however, with lower risk for hypoxia and lower pain scores, KM combination stands as a reasonable choice for orthopedic interventions in the emergency unit.
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Randomized Controlled Trial
A randomized, controlled trial to evaluate topical anesthetic for 15 minutes before venipuncture in pediatrics.
The aim of the study was to assess the differences in reported pain from venipuncture comparing liposomal 4% lidocaine with placebo cream in a pediatric population. Other factors assessed were patient anxiety, difficulty of venipuncture, and history of venipuncture. ⋯ Topical liposomal 4% lidocaine cream in this case did not prove to be effective with a 15-minute dwell time under occlusion because there were no differences in pain between study groups.
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Randomized Controlled Trial
Head position angles to open the upper airway differ less with the head positioned on a support.
The aim of the study was to assess the effects of positioning the head on a support on "head position angles" to optimally open the upper airway during bag-valve mask ventilation. ⋯ In the head-with-a-support group, when compared with the head-without-a-support group, head position angles differed less, indicating a decreased potential for failure during bag-valve mask ventilation with the head on a support. Moreover, in the head-with-a-support group, ventilation parameters differed less between head positions, and ventilation improved. These findings suggest a potential benefit of positioning the head on a support during bag-valve mask ventilation.
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Randomized Controlled Trial Comparative Study
Optimal external laryngeal manipulation: modified bimanual laryngoscopy.
External laryngeal manipulation (ELM) is commonly used to facilitate laryngeal view during direct laryngoscopy. We evaluated the effectiveness of the newly modified bimanual laryngoscopy, which involves a direct guidance of an assistant's hand by a laryngoscopist, to optimize laryngeal exposure during direct laryngoscopy compared with conventional bimanual laryngoscopy. ⋯ The modified bimanual laryngoscopy is more effective for obtaining the optimal laryngeal view on the first attempt compared with the conventional bimanual laryngoscopy.