Emergency medicine journal : EMJ
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MDMA (3,4-methylenedioxymethamphetamine, 'Ecstasy') produces tachycardia and hypertension and is rarely associated with cardiovascular and cerebrovascular complications. In clinical practice, beta-blockers are often withheld in patients with stimulant intoxication because they may increase hypertension and coronary artery vasospasm due to loss of beta(2)-mediated vasodilation and unopposed alpha-receptor activation. However, it is unknown whether beta-blockers affect the cardiovascular response to MDMA. ⋯ The results of this study indicate that beta-blockers may prevent increases in heart rate but not hypertensive and adverse effects of MDMA.
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Large, mainly North American, series has shown the safety of paediatric procedural sedation in the emergency department (ED). However, sedation practices elsewhere differ. This study set out to investigate the sedation practice and the associated adverse events profile at the largest Australian paediatric ED. ⋯ In variation to reported practice elsewhere, almost all procedures in this Australian series were undertaken using nitrous oxide and ketamine. The serious adverse events rate was low.