The American journal of emergency medicine
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Review Meta Analysis
Comparing the analgesic effect of intravenous paracetamol with morphine on patients with renal colic pain: A meta-analysis of randomized controlled studies.
The choice of intravenous paracetamol or morphine for the pain control of renal colic remains controversial. We conduct a systematic review and meta-analysis to compare the analgesic efficacy and safety of intravenous paracetamol with morphine for renal colic pain. ⋯ Intravenous paracetamol may result in lower pain scores at 30 min than morphine for renal colic pain, and more studies should be conducted to compare their analgesic efficacy.
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Review Meta Analysis
Comparative evaluation of the clinical safety and efficiency of supraclavicular and infraclavicular approaches for subclavian venous catheterization in adults: A meta-analysis.
In this meta-analysis, we investigated the success rate of subclavian venous catheterization (SVC) as well as the incidence of related complications when performed via the supraclavicular (SC) or traditional infraclavicular (IC) approaches. ⋯ Our findings suggest that SVC via the SC approach should be utilized in adults.
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The coronavirus disease of 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While systemic inflammation and pulmonary complications can result in significant morbidity and mortality, cardiovascular complications may also occur. ⋯ Emergency clinicians should be aware of these cardiovascular complications when evaluating and managing the patient with COVID-19.
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Handovers of care are necessary, yet a vulnerable time for patient safety. They can either reduce the risk of medical error during transitions of care or cause direct medical or financial harm to patients due to poor communication. ⋯ Descriptive themes of disrespect & disinterest, environmental factors, redundancy, poor recall, conflicting goals and perspectives, technological issues, information degradation, information loss, lack of standardization, lack of training, delays, and lack of feedback were identified as barriers to effective EMS to ED handovers. Three categories of interventions were identified across the included interventional studies, namely technological, educational, and changes to cultural customs.
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Cardiovascular disease is the leading cause of mortality and morbidity. Serial troponin tests have been endorsed as essential diagnostic steps to rule out/-in acute myocardial infarction (AMI), and hs-cTn assays have shown promise in enhancing the accuracy and efficiency of AMI diagnosis in the emergency department (ED). ⋯ Both hs-cTnI- and hs-cTnT-based accelerated diagnostic algorithms have high sensitivities but moderate specificities for early diagnosis of AMI. Overall, hs-cTnI-based algorithms have slightly higher specificities in early diagnosis of AMI. For patients presenting ED with typical symptoms, the use of hs-cTnT or hs-cTnI assays at the 99th percentile may help identify patients with low risk for AMI and promote early discharge from the ED.