The American journal of emergency medicine
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Observational Study
Association between fentanyl treatment for acute pain in the emergency department and opioid use two weeks after discharge.
Analgesia with fentanyl can be associated with hyperalgesia (higher sensitivity to pain) and can contribute to escalating opioid use. Our objective was to assess the relationship between emergency department (ED) acute pain management with fentanyl compared to other opioids, and the quantity of opioids consumed two-week after discharge. We hypothesized that the quantity of opioids consumed would be higher for patients treated with fentanyl compared to those treated with other opioids. ⋯ Patients treated with fentanyl during ED stay did not consume more opioids after ED discharge, compared to those treated with other opioids. If fentanyl does cause more hyperalgesia compared to other opioids, it does not seem to have a significant impact on opioid consumption after ED discharge.
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Observational Study
Impact of crowding in local ambulance demand on call-to-ambulance scene arrival in out-of-hospital cardiac arrest.
Rapid emergency medical service (EMS) response is an important prognostic factor in out-of-hospital cardiac arrest (OHCA). This study aims to evaluate the association between local hourly EMS demand and ambulance response in OHCA. ⋯ Crowding in local ambulance demand was associated with less ambulance dispatched within 1 km and delayed response to the scene in OHCA. Strategies to mitigate and adjust to ambulance demand crowding may be considered for better EMS response performance.
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To explore the clinical value of serum calcium (Ca) in elderly patients with sepsis. ⋯ Serum Ca has a certain value for the early recognition of elderly patients with sepsis and the judgment of the severity of the disease.
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To verify the role of lactate dehydrogenase to albumin (LDH/ALB) ratio as an independent prognostic factor for mortality due to the lower respiratory tract infection (LRTI) in the emergency department (ED). ⋯ The LDH/ALB ratio may serve as an independent prognostic factor for in-hospital mortality in patients with LRTI.
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Letter Meta Analysis
Efficacy and safety of ticagrelor use in pre-hospital setting.