Southern medical journal
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Southern medical journal · Apr 1999
Randomized Controlled Trial Clinical TrialTeaching telephone management skills to pediatric residents in a pilot program using a standardized patient.
Pediatricians spend a significant amount of time on the telephone but receive little formal training in telephone management skills. We found only two previous reports in the literature using a randomized controlled trial (RCT) that documented the effectiveness of a telephone management program for residents. ⋯ Further studies involving larger number of residents and revised study design are needed in planning effective approaches to teaching these important skills to pediatric residents in our training program.
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Southern medical journal · Mar 1998
Randomized Controlled Trial Clinical TrialUtility of dipstick urinalysis as a guide to management of adults with suspected infection or hematuria.
This study was done to determine whether emergency department (ED) patient management decisions made on the basis of dipstick urinalysis are altered when results of urine microscopy become available. ⋯ Dipstick urinalysis for blood or UTI is a reliable diagnostic test in ED patients. In 94% of patients, subsequent findings on urine microscopy did not prompt a change in management. Microscopy added nothing to dipstick results when clinicians suspected conditions causing hematuria alone. Primary use of dipstick urinalysis, with microscopy in selected cases, would likely result in considerable cost and time saving without compromising patient care.
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Southern medical journal · Dec 1996
Randomized Controlled Trial Clinical TrialEMLA cream as a topical anesthetic before office phlebotomy in children.
We studied the effectiveness of EMLA cream (2.5% lidocaine, 2.5% prilocaine) in reducing distress, anxiety, and pain associated with phlebotomy in pediatric outpatients. This was a randomized, double-blind, placebo-controlled study using EMLA cream or placebo 1 hour before phlebotomy. Distress, anticipatory anxiety, pain, and adverse reactions were measured. ⋯ Pain was decreased with use of EMLA cream. Anticipatory anxiety levels were equal within both groups. Ratings of cream efficacy by parent/observer scales were in favor of EMLA cream.
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Southern medical journal · Feb 1996
Randomized Controlled Trial Comparative Study Clinical TrialEye patch treatment for the pain of corneal abrasion.
The traditional use of patching and topical antibiotics in the treatment of corneal abrasion has recently been challenged, particularly after foreign body removal. In a prospective, controlled, randomized study of 33 patients treated in the emergency department for eye pain and corneal abrasion, we attempted to determine whether eye patching affected the pain of simple corneal abrasions. After fluorescein examination with magnification (x 5), a visual analog pain score was recorded and the patient was randomized to either the patched or nonpatched group. ⋯ There was no significant difference in the mean changes in pain scores between the patched and nonpatched groups. Analgesic use was also similar. We conclude that routine eye patching does not favorably affect the pain associated with the treatment of simple corneal abrasion.
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Southern medical journal · Nov 1994
Randomized Controlled Trial Clinical TrialLeft bronchial intubation by a single-lumen tube in adults: effects of bevel and curvature.
This study was designed to determine whether left bronchial intubation could be accomplished by reversal of the direction of the bevel or by changing the direction of curvature of a normal tracheal tube. The 60 study patients were divided into three groups. In group 1, the patients were intubated in the usual manner, with bevel to the left and the tube concave anteriorly. ⋯ In group 3, 18 tubes entered the right primary bronchus and 2 entered the left. The position of the bevel did not influence the positioning of the tracheal tube in the right or left bronchus. In summary, 90 degrees counterclockwise rotation from the usual position and altering the concavity of the tube to face the left significantly increased the likelihood of intubation of the left primary bronchus.