The American journal of emergency medicine
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It has not been investigated whether the quick sepsis-related organ failure assessment score (qSOFA), a new bedside tool for early sepsis detection, may help accelerating antibiotic initiation in ED patients with sepsis. ⋯ A qSOFA-based triage procedure does not improve antibiotic timing and outcomes in patients with sepsis admitted to a high-volume ED. The qSOFA value at triage was poorly sensitive for early sepsis detection. Trial registration (ClinicalTrials.gov): NCT03299894.
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Review Meta Analysis
The influency of Nigella sativa for asthma control: A meta-analysis.
The efficacy of Nigella sativa supplementation for asthma control remains controversial. We conduct a systematic review and meta-analysis to explore the influence of Nigella sativa supplementation on asthma control. ⋯ Nigella sativa supplementation may provide additional benefits for the treatment of asthma.
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Review Meta Analysis
Ketamine for emergency sedation of agitated patients: A systematic review and meta-analysis.
Prior studies suggest that ketamine is effective for acute agitation in the emergency department (ED) and prehospital settings. This systematic review and meta-analysis aims to evaluate the rate of sedation and need for airway management in patients given ketamine for management of acute agitation. Methods: We performed a systematic review of publications describing the use of ketamine to control agitation in the ED and prehospital settings. ⋯ The estimate of the proportion of subjects that achieved sedation was 85% (95% CI = 0.71-0.93). After synthesizing data from the four studies that compared ketamine to controls, ketamine was associated with increased rates of sedation (RR, 1.95 [CI, 0.47-8.1]) and increased need for intubation (RR, 2.44 [CI, 0.75-7.91]). The differences were not significant by random effects model.
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Multicenter Study Comparative Study
Assessment of dextrose 50 bolus versus dextrose 10 infusion in the management of hyperkalemia in the emergency department.
Hypoglycemia is a common adverse effect when intravenous (IV) insulin is administered for hyperkalemia. A prolonged infusion of dextrose 10% (D10) may mitigate hypoglycemia compared to dextrose 50% (D50) bolus. Our objective was to evaluate whether D10 infusion is a safe and effective alternative to D50 bolus for hypoglycemia prevention in hyperkalemic patients receiving IV insulin. ⋯ In our study, D10 infusions appeared to be at least as effective as D50 bolus in preventing hypoglycemia in hyperkalemic patients receiving IV insulin. In context of ongoing D50 injection shortages, D10 infusions should be a therapeutic strategy in this patient population.