The American journal of emergency medicine
-
Randomized Controlled Trial Comparative Study
Comparison of ketamine-low-dose midozolam with midazolam-fentanyl for orthopedic emergencies: a double-blind randomized trial.
Most of the fractures and dislocations are reduced in the emergency setting. Many drugs are available for procedural sedation and analgesia in the emergency department (ED); however, the adverse effects are still a common problem. The aim of our study was to compare the 2 drug combinations. ⋯ Both drug combinations can be effectively used for procedural sedation and analgesia; however, with lower risk for hypoxia and lower pain scores, KM combination stands as a reasonable choice for orthopedic interventions in the emergency unit.
-
Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events. ⋯ Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
-
Randomized Controlled Trial
A randomized, controlled trial to evaluate topical anesthetic for 15 minutes before venipuncture in pediatrics.
The aim of the study was to assess the differences in reported pain from venipuncture comparing liposomal 4% lidocaine with placebo cream in a pediatric population. Other factors assessed were patient anxiety, difficulty of venipuncture, and history of venipuncture. ⋯ Topical liposomal 4% lidocaine cream in this case did not prove to be effective with a 15-minute dwell time under occlusion because there were no differences in pain between study groups.
-
Review Case Reports
Empty toe: a unique type of closed degloving injury with dismal outcome.
Closed degloving injury is characterized by the development of soft tissue separated from underlying structure without outer skin disruption. “Empty toe” is one of the most unique types of closed degloving injuries. Only 4 such injuries have been reported previously. We demonstrate a case of this entity in a 20-year-old scooter passenger. ⋯ The fifth toe was eventually amputated. An empty toe implies that the injured site has experienced severe compressive and shearing force with potential neurovascular damage. Health care providers should be fully aware of the high risk of the probability of vascular insufficiency, and the viability would be associated with vascular capability.