The American journal of emergency medicine
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Clinical Trial
Use and efficacy of nebulized naloxone in patients with suspected opioid intoxication.
To describe the use and efficacy of nebulized naloxone in patients with suspected opioid intoxication. ⋯ Nebulized naloxone was well-tolerated and led to a reduction in the need for supplemental oxygen as well as improved median GCS and RASS scores in patients with suspected opioid intoxication.
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Clinical Trial
Systematic combined noncontrast CT-CT angiography in the management of unexplained nontraumatic coma.
Nontraumatic impaired consciousness is a common issue in emergency departments with a serious but widely variable prognosis. ⋯ Systematic combined NCCT/CTA imaging is an efficient tool for predicting poor neurologic prognosis in cases of unexplained nontraumatic impaired consciousness and is also essential for detecting BAO.
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Comparative Study Clinical Trial
Pocket mobile smartphone system for the point-of-care submandibular ultrasonography.
Focused ultrasonography of the airway may be useful in the prediction of difficult intubation. The wider use of sonography in quantitative airway assessment may depend on the availability of highly portable, inexpensive, and accurate ultrasound systems. Pocket-sized ultrasound devices are emerging as a useful tool for point-of-care ultrasonography. The aim of this study was to evaluate the suprahyoid airway of healthy volunteers using a smartphone-based ultrasound imaging system in comparison with a platform-based machine. ⋯ Mobisante MobiUS system was able to acquire clinically useful images of the suprahyoid airway and muscular architecture in the mouth floor and allowed accurate measurements of linear distances.
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Clinical Trial
Derivation of a clinical prediction rule to predict hospitalization for influenza in EDs.
Early, rapid, and accurate identification of those patients who have severe influenza is important for emergency physicians. Influenza viral load, which has been proposed as a predictor of severe influenza, could be useful in facilitating decision making of resource use. We aimed to derive a clinical prediction rule to indicate probability for inpatient hospitalization for patients with influenza, which includes influenza viral load in addition to other clinical information commonly collected in the emergency department (ED). ⋯ The clinical prediction rule incorporating influenza viral load into the clinical information was indicative of hospitalization and merits further evaluation for determination of ED resource use for patients with influenza.
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Cocaine is the most commonly abused illegal drug in patients presenting to emergency departments (EDs) because of chest pain and accounts for almost 40% of all drug-related visits. It is not known whether all β-blockers (BB) and β1-selective agents or mixed α1/β-adrenergic antagonists (α1/β-BB) are safe in the acute management of cocaine-associated chest pain, due to concerns of unopposed α-receptor activity resulting in coronary artery spasm and hypertensive urgency. ⋯ Troponin rise is not uncommon in patients with cocaine-associated chest pain and occurred in 11% of the patients. In patients with cocaine-associated chest pain, BBs did not appear to change the incidence of troponin rise. β1-Selective BBs did not appear to worsen troponin levels compared with mixed α1/β-BB.