The American journal of emergency medicine
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Randomized Controlled Trial Comparative Study
Efficacy and safety of nebulized morphine given at 2 different doses compared to intravenous titrated morphine in trauma pain.
Our aim was to compare the efficacy and safety of intravenous (IV) titrated morphine with nebulized morphine given at 2 different doses in severe traumatic pain. ⋯ Nebulized morphine using boluses of 10 mg has similar efficacy and better safety than IV titrated morphine in patients with severe posttraumatic pain. Increasing nebulized boluses to 20 mg increases the effectiveness without increasing side effects.
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Multicenter Study Observational Study
Association between time to percutaneous coronary intervention and hospital mortality in non-ST-elevation myocardial infarction: a prospective multicenter observational study.
This study aimed to investigate the association between time to percutaneous coronary intervention (PCI) and hospital mortality in non-ST-elevation myocardial infarction (NSTEMI). ⋯ Percutaneous coronary intervention earlier than 6 hours after ED presentation was associated with higher hospital mortality than PCI 6 hours later in NSTEMI. However, the effect disappeared in the long S2D group.
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Randomized Controlled Trial
Child endotracheal intubation with a Clarus Levitan fiberoptic stylet vs Macintosh laryngoscope during resuscitation performed by paramedics: a randomized crossover manikin trial.
The main cause of cardiac arrest in pediatric patients is respiratory failure. ⋯ This study suggested that the FPS could be used as an option for airway management even for paramedics with little experience. Future studies should explore the efficacy of FPS in pediatric clinical emergency settings.
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Observational Study
Lack of adverse effects from flumazenil administration: an ED observational study.
Flumazenil is an effective benzodiazepine (BZD) antagonist. Empiric use of flumazenil in the emergency department (ED) is not widely recommended due to concerns of seizures, which are commonly associated with coingestants and BZD withdrawal. ⋯ A majority of patients had improved mental status after the administration of flumazenil. No patient experienced seizures. Additional studies that clarify the role of flumazenil for ED patients with suspected BZD toxicity are warranted.