The American journal of emergency medicine
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Meta Analysis
Significant association between anemia and higher risk for COVID-19 mortality: A meta-analysis of adjusted effect estimates.
This study aimed to evaluate whether there was a significant relationship between anemia and the risk for mortality among coronavirus disease 2019 (COVID-19) patients by a quantitative meta-analysis based on the adjusted effect estimates. ⋯ Our meta-analysis based on risk factors-adjusted effect estimates indicated that anemia was independently associated with a significantly elevated risk for mortality among COVID-19 patients.
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Randomized Controlled Trial
Comparison of saline versus air for identifying endotracheal intubation with ultrasound.
After intubation has been performed, it is important to rapidly confirm the correct location of the endotracheal tube (ETT). Multiple techniques have been described, each with different limitations. Ultrasound has been increasingly recognized as an alternate modality for identifying the ETT location. However, it can be challenging to visualize the air-filled ETT cuff. Saline insufflation of the ETT cuff has been suggested to improve visualization of the ETT but data are limited. Our study sought to compare the diagnostic accuracy of air versus saline ETT cuff inflation on the diagnostic accuracy of intubation. ⋯ There was no statistically significant difference between air versus saline for intubation confirmation. However, saline was associated with fewer false negatives. Additionally, time to confirmation was faster and operator confidence was higher with the saline group. Further studies should determine if the outcomes would change with more novice sonographers or in specific patient populations.
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Pain is a common complaint precipitating emergency department (ED) visit, occurring in more than half of patient encounters. While opioids are effective for acute pain management in the Emergency Department (ED), the associated adverse effects, including respiratory and central nervous system depression, nausea, vomiting, and constipation, and physical manifestations of use, including tolerance, dependence and misuse leading to overdose and death, accentuate the need for non-opioid alternatives and/or multi-modal pain control. This review will provide examples of non-opioid pain management strategies and multimodal regimens for treatment of acute pain in the ED.
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Emergency medicine (EM) research is growing at a rapid pace. It is important to understand the scope and trends over time in order to identify gaps and future areas for growth. This study aimed to describe trends in scientific publications within EM over the past decade. ⋯ This bibliometric study is a quick snapshot of research in the EM field in the last decade and may provide insights into the scientific agendas of the EM professionals.
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Buprenorphine precipitated opioid withdrawal (BPOW) is an uncommon complication of buprenorphine initiation in the emergency department (ED), but it can produce significant discomfort and be distressing to patients. As EDs continue to care for those with opioid use disorder (OUD), clinicians should be aware of how to prevent and treat BPOW. ⋯ Appropriate initiation of buprenorphine is important to prevent BPOW. Dosing buprenorphine should be based on the patient's patterns of opioid use and response to therapy. Management of BPOW should be symptom-based but include additional buprenorphine and adjunctive medications.