Can J Emerg Med
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Randomized Controlled Trial
Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial.
Article chosen Ebinger M, Winter B, Wendt M, et al. Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial. JAMA 2014;311(16):1622-31. Clinical question Does prehospital thrombolysis in specialized ambulances reduce delay to thrombolysis in acute ischemic stroke? ⋯ To determine the effect of prehospital thrombolysis for acute ischemic stroke administered in specialized ambulances on delay in thrombolytic administration, thrombolysis rate, post-thrombolysis intracerebral hemorrhage, and 7-day mortality.
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Randomized Controlled Trial Multicenter Study
Targeted temperature management: It is not yet time to change your target temperature.
Clinical question In unconscious patients of out-of-hospital cardiac arrest, does targeted temperature management to 36°C (96.8°F) improve outcomes compared to the standard target of 32°C-34°C (89.6°F-93.2°F)? Article chosen Nielson N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369:2197-2206. ⋯ To determine which temperature, 33°C (91.4°F) or 36°C (96.8°F), is associated with lower mortality and better neurologic function after cardiac arrest.
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Randomized Controlled Trial
Transfusion strategy for acute upper gastrointestinal bleeding.
Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. ⋯ Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.
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Randomized Controlled Trial
Effect of pain control in suspected acute appendicitis on the diagnostic accuracy of surgical residents.
To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents. ⋯ Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
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Randomized Controlled Trial
Randomized controlled trial of a nursing intervention to reduce emergency department revisits.
To determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits. ⋯ These findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings.