European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Meta Analysis
The use of intravenous magnesium sulphate for acute migraine: meta-analysis of randomized controlled trials.
The objective of this study was to assess the efficacy and tolerability of intravenous magnesium for the treatment of acute migraine in adults. ⋯ The meta-analyses have failed to demonstrate a beneficial effect of intravenous magnesium in terms of reduction in pain relief in acute migraine in adults, showed no benefit in terms of the need for rescue medication and in fact have shown that patients treated with magnesium were significantly more likely to report side-effects/adverse events.
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To investigate the prevalence, etiology, and symptoms of severe hypokalemia in patients presenting to the emergency department. ⋯ Hypokalemia is common in the emergency department. Severe hypokalemia is often symptomatic and more than two-thirds of patients show ECG changes.
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Observational Study
Inter-rater agreement of the triage system RETTS-HEV.
The purpose of this study was to evaluate the inter-rater agreement among nurses using the triage system RETTS-HEV (rapid emergency triage and treatment system - hospital unit west) in a Danish emergency department (ED). ⋯ The study found good inter-rater agreement between two independent observers not receiving any new triage training before the study.
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Comparative Study
Intubation by paramedics using the ILMA or AirTraq, KingVision, and Macintosh laryngoscopes in vehicle-entrapped patients: a manikin study.
Four devices were compared in a simulated scenario of a vehicle-entrapped patient: standard Macintosh laryngoscope, intubating laryngeal mask (ILMA), AirTraq optical laryngoscope, and KingVision videolaryngoscope. A group of 30 final-year paramedic students intubated a manikin placed in a sitting position under a desk simulating the roof of a car. ⋯ The mean time to intubation was 13.9±6.6, 24.7±4.7, 25.2±3.7, and 23.9±4.2 s; the first attempt success ratios for devices were 29/30, 18/30, 6/30, and 18/30; and the baseline time of intubation was 14.3±6.5, 16.7±4.7, 22.9±12.6, and 18.1±5.0 s for ILMA, Macintosh laryngoscope, Airtraq, and KingVision, respectively. In emergency situations with very limited access to the patient, ILMA is the most effective device for intubation by paramedics.
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Randomized Controlled Trial
Use of predefined biochemical admission profiles does not reduce the number of tests or total cost: a randomized-controlled pilot study.
The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost. ⋯ The use of a predefined blood test panel did not significantly affect the number of tests, total cost, or length of stay for acutely admitted medical patients compared with tests ordered at the discretion of the treating physician.