J Emerg Med
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Randomized Controlled Trial Comparative Study Clinical Trial
Benzyl alcohol with epinephrine as an alternative to lidocaine with epinephrine.
A randomized, prospective, double-blind study comparing benzyl alcohol with epinephrine, 1:100,000 (BA), and lidocaine with epinephrine, 1:100,000 (LID), as local anesthetics was carried out on adult patients with simple lacerations. The two study groups were compared for pain of infiltration (100 mm visual analog scale) and need for additional anesthesia. Pain scores were compared by a Mann Whitney Independent Rank Sum test and need for additional anesthesia by a Fishers Exact test. ⋯ The median pain score for BA, 7.5 mm, was less than for LID, 19.5 mm (p = 0.049). Although more patients receiving BA required additional anesthesia as compared to LID (8/26 versus 2/26), this difference did not reach statistical significance. BA is a reasonable alternative local anesthetic to LID for patients who are allergic to LID.
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Randomized Controlled Trial Clinical Trial
Home administration of charcoal: can mothers administer a therapeutic dose?
This study evaluated whether children under 3 years of age would drink a therapeutic dose of activated charcoal (AC) in a simulated home environment. Children 13 to 35 months participated with their mothers. Children were randomly assigned to receive AC mixed with regular cola or with diet cola. ⋯ The potential for failure of home AC administration needs to be considered when making the decision to recommend home stocking of AC. Mixing AC with cola does not ensure successful administration. Diet cola does not appear to be an alternative.
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Randomized Controlled Trial Clinical Trial
A prospective, randomized trial of BiPAP in severe acute congestive heart failure.
Noninvasive positive pressure ventilation has been found to be efficacious in the setting of acute respiratory failure, specifically in chronic obstructive pulmonary disease exacerbations. Its use in congestive heart failure (CHF) is less well established. Additionally, it has been reported that there is an increase in acute myocardial infarction (AMI) rate with the use of bilevel positive pressure ventilation (BiPAP) in CHF patients. ⋯ No true differences were detected between groups for increased oxygenation or a reduction in intubation rate. An increase in AMI rate with BiPAP was not found in this study as previously reported. This study provides support for a larger clinical trial assessing the safety and efficacy of BiPAP in acute CHF.