The American journal of emergency medicine
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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 Comparative Study
Comparison of Xenon with LED illuminant in difficult and inhalation injury airway scenario: A randomized crossover manikin study.
The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. ⋯ The LED laryngoscope light handle did not affect the recorded intubation times in the simulated difficult airway scenario, but provided significant advantages in the inhalation injury airway scenario that combines a difficult airway with a limited view caused by a sooted pharynx. We therefore hypothesize, that the LED illuminant might be beneficial in the airway management of burn patients with severe inhalation injury.
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Case Reports
Transient vocal cord paralysis following central venous hemodialysis catheter insertion.
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. ⋯ We think temporary vocal cord palsy in our case was due to local anesthetic infiltration rather than nerve injury, since it resolved spontaneously within only hours. Expectant treatment is a good choice ensuring the patient's airway is safe. Emergency physicians should be aware of this rare complication and its right management.
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Ultrasound is an ideal modality in the emergency department (ED) to assess for pneumothorax given its rapid availability, portability, and repeatability to assess clinical status changes. Certain patient populations and clinical circumstances may present challenges to the performance of this examination. In this article, we review patterns of the presence or absence of lung sliding in the commonly utilized sonographic modes in the ED setting. We also describe a novel technique to evaluate lung sliding using tissue Doppler.
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Randomized Controlled Trial
The effect of trimetazidine treatment in patients with type 2 diabetes undergoing percutaneous coronary intervention for acute myocardial infarction.
Trimetazidine (TMZ) improves clinical outcomes in patients with chronic heart failure and stable coronary artery disease. No study has yet evaluated the efficacy of TMZ in type 2 diabetes patients with acute myocardial infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI). We performed this study to evaluate the efficacy TMZ in DM patients with AMI undergoing PCI, such as the effect on reductions in myocardial enzyme, improvements in liver function, modulation of glucose levels, and improvement in cardiac function. ⋯ Among type 2 diabetic patients with AMI undergoing PCI, TMZ significantly reduces serum myocardial enzyme, improves liver function, adjusts blood glucose and improves cardiac function.