Archives of emergency medicine
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Randomized Controlled Trial Clinical Trial
The MiniCAP III CO2 Detector: assessment of a device to distinguish oesophageal from tracheal intubation.
A new portable infra-red CO2 detector was assessed in 50 intubated patients. This device was 100% accurate in distinguishing between tracheal and oesophageal intubation when used by nursing and paramedic personnel.
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Randomized Controlled Trial Clinical Trial
Reducing the pain of intradermal lignocaine injection by pH buffering.
The effect of pH on the pain of administration and efficacy of 1% lignocaine was investigated in a prospective, double-blind, randomized study of 20 adult volunteers. Onset and spread of anaesthesia by intra-dermal injection were not altered, but there was a significant reduction in pain scores with a higher pH. Overall, pain scores appear to be more dependent on the speed of injection rather than alteration of pH.
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Randomized Controlled Trial Clinical Trial
A comparative double blind study of amoxycillin/clavulanate vs placebo in the prevention of infection after animal bites.
The value of prophylactic antibiotics in the treatment of animal bites is uncertain. A prospective double blind stratified trial was performed comparing a broad spectrum antibiotic amoxycillin/clavulanate with placebo in full thickness animal bite wounds in a series of 185 consecutive patients. ⋯ In older wounds, presenting 9-24 h after injury, the infection rate was reduced significantly (P = 0.023), although the numbers were small. We recommend the use of such an antibiotic on wounds 9-24 h old and query its use in more recent injuries, unless tendons or joints are likely to be involved.
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Randomized Controlled Trial Comparative Study Clinical Trial
Dog-bite lacerations: a controlled trial of primary wound closure.
Dog-bite wounds are often left open because of their reputation for infection if primarily closed. A prospective randomized trial comparing primary closure with leaving the wound open was performed to assess infection and cosmesis. Ninety-six patients with 169 lacerations had thorough surgical debridement and irrigation of their wounds. ⋯ Significantly (P less than 0.01), more wound infections occurred in the hand in both groups compared to the rest of the body, indicating that particular attention should be paid to management of such wounds. It was concluded that dog-bite wounds should receive thorough surgical treatment and can be safely sutured at presentation. Special care should be given to hand wounds.