The American journal of emergency medicine
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Randomized Controlled Trial
Comparing intranasal ketamine with intravenous fentanyl in reducing pain in patients with renal colic: A double-blind randomized clinical trial.
Kidney stones are a fairly common problem that manifests itself as symptoms of acute abdominal and flank pains in patients presenting to emergency departments. ⋯ Ketamine was found to be less effective than fentanyl in controlling renal colic-induced pain, and to be associated with a higher prevalence of side-effects; nevertheless, ketamine can be effective in controlling this pain in conjunction with other medications.
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Randomized Controlled Trial
Kinesiotaping for isolated rib fractures in emergency department.
Rib fractures, which are among the most common injuries in blunt thoracic trauma, are usually encountered in Emergency Departments. Kinesiotape (KT) is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems such as injury, dysfunction and pain. We aimed to investigate whether kinesotaping should be used safely and effectively in rib fractures in emergency setting. ⋯ This study investigated the use of kinesiotaping in emergency departments. When compared to NSAID therapy alone, combined kinesiotaping and NSAID therapy appears to be more effective in terms of pain reduction in rib fractures.
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The purpose of this review is to provide a brief overview of new life-saving interventions and novel techniques that have been proposed as viable treatment options for patients presenting with refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) out-of-hospital cardiac arrest (OHCA). ⋯ We would like to suggest that there is not enough evidence in the existing literature to support at large-scale the effects of these techniques in the treatment of refractory VF/pVT OHCA. Randomized studies are warranted to evaluate the significant effects of these approaches against the best current standard of care.
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Randomized Controlled Trial
Is it feasible "scoop and run while playing" resuscitation on a rescue water craft? A randomized simulation study with lifeguards.
Response time is a predictive factor for survival of drowning victims and lifesaving. Rescue Water Craft (RWC) are lifeboats very common in lifeguards operations. The aim of this study was to analyze the feasibility of providing effective mouth-to-mouth ventilations and/or cardiopulmonary resuscitation (CPR) on the RWC while sailing at different speeds. ⋯ Resuscitation techniques on board of a RWC are feasible and therefore they could be an option for lifeguards when their training, sea conditions, distance and the victim's characteristics allow it. CPR maneuvers may be highly effective at 10 kn, both for MM-only and CPR, however, the quality of the ventilations dramatically worsen with increasing speed.
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Haloperidol and ketorolac have been recommended as therapies that may decrease opioid use for treatment of pain in emergency department patients. The objective of our study is to determine if administration of haloperidol or ketorolac is associated with lower use of i.v. opioids for patients with non-specific abdominal pain. ⋯ Haloperidol was not associated with decreased i.v. opioid use. Ketorolac was associated with a modest decrease in i.v. opioid use. Providers should consider the use of haloperidol and ketorolac as potentially beneficial in some cases, but there is a need for high quality studies before they can be recommended as standard therapy.