Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Negative predictive value of acetaminophen concentrations within four hours of ingestion.
The objective was to ascertain whether acetaminophen (APAP) concentrations less than 100 μg/mL obtained between 1 and 4 hours after acute ingestion accurately predict a nontoxic 4-hour concentration. ⋯ An APAP concentration of <100 μg/mL obtained between 1 and 4 hours after ingestion has a high NPV for excluding toxic ingestion. We do not recommend reliance on concentrations obtained between 1 and 4 hours to exclude toxicity, because of a potential false-negative rate of 6.5%.
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Observational Study
Intranasal Ketamine for Analgesia in the Emergency Department: A Prospective Observational Series.
The objective was to examine the feasibility, effectiveness, and adverse effect profile of intranasal ketamine for analgesia in emergency department (ED) patients. ⋯ Intranasal ketamine reduced VAS pain scores to a clinically significant degree in 88% of ED patients in this series. Adverse effects were minor and transient. Intranasal ketamine may have a role in the provision of effective, expeditious analgesia to ED patients.
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Low back pain (LBP) is a common reason for emergency department (ED) visits in the United States. Pain and functional outcomes after ED visits for LBP tend to be poor. ED-based clinical LBP research is hampered by complexity of available outcome instruments, which can be time-consuming to administer. The purpose of this investigation was to determine if a shorter version of the well-validated and commonly used Roland Morris Disability Questionnaire (RMDQ) would retain the original 24-item instrument's ability to assess functional outcomes accurately in ED patients with LBP. ⋯ An abbreviated five-item version of the RMDQ was developed. Pending independent validation, this shortened instrument should streamline ED-based low back pain research.