The American journal of emergency medicine
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Undifferentiated abdominal pain is a common condition encountered in the emergency department. While a patient's age, risk factors, and comorbidities often aid in risk stratification and guide emergency department evaluation, atypical presentations of serious disease may still occur suddenly in young otherwise healthy patients. ⋯ Emergency physicians regularly encounter uncommon causes of abdominal pain. Wunderlich's syndrome is rare but proper understanding of the disease process will aid in decision making and improve disposition and outcomes for patients. Likely presentations and risk factors for atraumatic renal rupture will be discussed as well as ED management and definitive treatment options.
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Review Meta Analysis
Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis.
Greater occipital nerve (GON) block may be a promising approach to treat migraine. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of GON block in migraine patients. ⋯ Compared to control intervention, GON block intervention can significantly alleviate pain, reduce the number of headache days and medication consumption, but have no significant influence on the duration of headache per four weeks for migraine patients.
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Randomized Controlled Trial
Does the novel lateral trauma position cause more motion in an unstable cervical spine injury than the logroll maneuver?
Prehospital personnel who lack advanced airway management training must rely on basic techniques when transporting unconscious trauma patients. The supine position is associated with a loss of airway patency when compared to lateral recumbent positions. Thus, an inherent conflict exists between securing an open airway using the recovery position and maintaining spinal immobilization in the supine position. The lateral trauma position is a novel technique that aims to combine airway management with spinal precautions. The objective of this study was to compare the spinal motion allowed by the novel lateral trauma position and the well-established log-roll maneuver. ⋯ In this cadaver study, the novel lateral trauma position and the well-established log-roll maneuver resulted in comparable amounts of motion in an unstable cervical spine injury model. We suggest that the lateral trauma position may be considered for unconscious non-intubated trauma patients.
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Randomized Controlled Trial Comparative Study
Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial.
The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). ⋯ This study suggests that modified VM therapy was more effective than standard VM for terminating PSVT. The modified VM therapy also indirectly reduced the need for anti-arrhythmic medication and indirectly caused fewer side effects.