J Emerg Med
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Randomized Controlled Trial
Treatment of Headache in the Emergency Department: Haloperidol in the Acute Setting (THE-HA Study): A Randomized Clinical Trial.
Headache is a common complaint of emergency department (ED) patients and current treatment varies with significant limitations. ⋯ This study suggests that 2.5 mg i.v. haloperidol is a rapid and effective treatment for acute, severe, benign headache in ED patients aged 18 to 55 years. Further study is warranted to confirm these results in adolescents.
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Randomized Controlled Trial
Effects of Using an Endotracheal Tube Introducer for Intubation During Mechanical Chest Compressions of a Manikin: Randomized, Prospective, Crossover Study.
Airway management methods during out-of-hospital cardiac arrest remain controversial. ⋯ The use of an endotracheal tube introducer as an adjunct to a Macintosh laryngoscope is not associated with higher first-pass success rates during mechanical chest compressions in adult simulations performed by final-year medical students. © 2020 Elsevier Inc.
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Children present to the pediatric emergency department (ED) with enlarged lymph nodes due to a broad spectrum of conditions ranging from benign causes like reactive lymph nodes to adverse conditions like malignancy. Identifying sonographic features typical of infection, inflammation, and neoplasms will help assist clinicians in deciding the disposition of the patients from the ED. Point-of-care ultrasound has become an essential adjunct for diagnostic assessment in pediatric emergency medicine. The wider accessibility of ultrasound along with greater resolution using high-frequency probes places this noninvasive, nonradiation-based bedside examination, an ideal tool for real-time examination of the lymph nodes in the EDs. ⋯ We present a series of cases in which the point-of-care ultrasound examination proved valuable in the timely diagnosis and expedited care of lymph node pathologies secondary to reactive, infectious, and malignant processes. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Point-of-care ultrasound will facilitate diagnosis in children with lymph node swelling and should be considered in children of all ages. While assessing the lymph node pathology at the bedside, describe the shape, size, internal echotexture, borders, vascularity, and the pattern of the perinodal soft tissue to differentiate between a normal, reactive, infectious, inflammatory, or malignant underlying pathology.
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Stimulant poisoning frequently causes altered mental status (AMS) and can result in severe cerebral vascular complications. The role of noncontrast brain computed tomography (CT) in acute stimulant-poisoned patients presenting with AMS remains unclear. ⋯ Nontrauma stimulant-poisoned patients presenting with AMS and without focal neurologic symptoms were unlikely to have acute abnormalities on brain CT. Patients who underwent brain CT scans had worse consciousness and greater disease severity.