Articles: emergency-services.
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Randomized Controlled Trial
Efficacy and safety of intranasal lorazepam versus intramuscular paraldehyde for protracted convulsions in children: an open randomised trial.
In sub-Saharan Africa, rectal diazepam or intramuscular paraldehyde are commonly used as first-line anticonvulsant agents in the emergency treatment of seizures in children. These treatments can be expensive and sometimes toxic. We aimed to assess a drug and delivery system that is potentially more effective, safer, and easier to administer than those presently in use. ⋯ Intranasal lorazepam is effective, safe, and provides a less invasive alternative to intramuscular paraldehyde in children with protracted convulsions. The ease of use of this drug makes it an attractive and preferable prehospital treatment option.
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Arch Pediat Adol Med · May 2006
Randomized Controlled TrialImproved asthma outcomes in a high-morbidity pediatric population: results of an emergency department-based randomized clinical trial.
To determine if an emergency department-based asthma follow-up clinic could improve outcomes within a high-morbidity pediatric population. ⋯ Attendance in the follow-up clinic was high. The intervention decreased subsequent unscheduled health care use while improving compliance and quality of life.
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Randomized Controlled Trial
Announcing the emergent patient in the emergency department: a randomised trial.
To determine which of three commonly used methods for notifying medical staff of the arrival of an emergent case to the triage area of an emergency department (ED) is optimal. ⋯ A microphone announcement heard by overhead speakers should be incorporated with other strategies to improve the timeliness of medical assessment of emergent cases.
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Randomized Controlled Trial
Emergency department allies: a controlled trial of two emergency department-based follow-up interventions to improve asthma outcomes in children.
We sought to study the impact of emergency department (ED)-based intensive primary care linkage and initiation of asthma case management on long-term, patient-oriented outcomes for children with an asthma exacerbation. ⋯ ED-based attempts to improve primary care linkage or initiate case management are no more effective than our standard ED care in improving subsequent asthma outcomes over a 6-month period.
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Randomized Controlled Trial Comparative Study
The decision to use topical anesthetic for intravenous insertion in the pediatric emergency department.
Topical anesthetic creams to reduce the pain of intravenous (IV) placement may be more effectively used in the emergency setting if they are applied by nurses in the triage area of the emergency department or soon after the patient is placed into a room. This strategy requires accurate prediction of which patients will require IV placement. The objective of this study was to compare triage nurse judgment regarding IV placement in pediatric patients with a triage prediction rule using chief complaint, referral status, and high-risk medical history. A secondary objective was to evaluate whether the presence of the anesthetic cream placed in triage influenced the subsequent decision to place an IV and thus invalidate the prediction strategy. ⋯ Triage nurse judgment to predict eventual IV placement had greater sensitivity and similar predictive value compared with a prediction model based on medical history and chief complaint. The triage placement of topical anesthetic in pediatric patients did not change the eventual rate of IV placement.