The American journal of emergency medicine
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The aim of this study was to introduce a continuous monitoring of side effects related to sedation-analgesia in the field. A document was completed by physicians on board the ambulances for all prehospital interventions and checked daily by the medical staff. A total of 3605 interventions were evaluated over a 12-month period. ⋯ Side effects were observed in 5.5% in group 1 (nausea: 2%, hypotension: 1%, hypoxemia: 1%) and 22% of patients in group 2 (hypotension-arrhythmia: 12%, cardiac arrest: 2%, difficult intubation: 5%, hypoxemia: 1%, pulmonary aspiration: 1%, laryngospasm/bronchospasm: 2%). No death was related to these medications. A close monitoring of side effects related to sedation-analgesia must be included in a quality program to improve patient safety in the field.
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Randomized Controlled Trial Clinical Trial
Violence prevention in the ED: linkage of the ED to a social service agency.
Interpersonal violence continues to be a problem in the United States, most prominent in the inner-city minority young persons population. The medical approach of "treat 'em and street 'em" philosophy has led to foregoing the psychosocial needs of injured young persons. This study describes a program to link young persons who are victims of interpersonal violence to a healthcare system and a social service agency in an effort to meet their psychosocial needs. ⋯ Nine of the 92 (9.8%) in the control group used services; most of these referrals were for social services (7 of 9 respondents) and the others were healthcare-related. The difference in utilization of services between the treatment and the control groups were found to be significant different (95% confidence interval, 1.41-1.55, significance =.00), and there was a strong positive correlation of using services and case management (Pearson coefficient = 0.728, significance =.00). The referral of young victims of violence from the ED to psychosocial services could be successful using a case management model and an alliance between a healthcare system and a social service agency.
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Clinical Trial Controlled Clinical Trial
Increased blood lead levels in severe smoke inhalation.
Lead-containing paint is common in structures built before 1977. Heated lead in burning paint can be aerosolized and absorbed directly into the bloodstream through the lungs. Acute lead intoxication has been reported in this setting. ⋯ Among the 44 matched control subjects, mean lead level was 2.89 mug/dL (SD, 1.65 mug/dL). The mean difference between cases and control subjects was 3.75 mug/dL (95% confidence interval, 1.86-5.64). Although severe smoke inhalation is associated with a more than 2-fold statistically significant increase in blood lead levels, there is no evidence to suggest that these elevations are clinically important.
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Letter Case Reports
Use of pharmaceutical promotility agents in the treatment of body packers.