Articles: emergency-services.
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Randomized Controlled Trial Multicenter Study
The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial: a randomised controlled trial of point-of-care cardiac markers in the emergency department.
To determine whether using a point-of-care cardiac biomarker panel would increase the rate of successful discharge home after emergency department assessment, and affect the use of cardiac tests and treatments, subsequent attendance at or admission to hospital and major adverse events. ⋯ Point-of-care panel assessment increases successful discharge home and reduces median length of stay, but does not alter overall hospital bed use.
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Intensive care medicine · Feb 2011
Randomized Controlled Trial Multicenter StudyNon-invasive pressure support ventilation and CPAP in cardiogenic pulmonary edema: a multicenter randomized study in the emergency department.
Noninvasive pressure support ventilation (NIPSV) and continuous positive airway pressure (CPAP) are both advocated in the treatment of cardiogenic pulmonary edema (CPE); however, the superiority of one technique over the other has not been clearly demonstrated. With regard to its physiological effects, we hypothesized that NIPSV would be better than CPAP in terms of clinical benefit. ⋯ During CPE, NIPSV accelerates the improvement of respiratory failure compared to CPAP but does not affect primary clinical outcome either in overall population or in subgroups of patients with hypercapnia or those with high B-type natriuretic peptide.
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Multicenter Study
Quality of pain management in the emergency department: results of a multicentre prospective study.
The purpose of this study was to evaluate pain management in a large sample of emergency departments (EDs) and identify potential corrective measures. METHOLOGY: A multicentre prospective study was performed in 50 EDs participating in a national quality improvement programme. The rate of inclusion was determined a priori in each ED. Patients were questioned about their pain and pain intensity was assessed by a visual analogue scale. A bivariate and a multivariate analysis were conducted to identify the criteria associated with inadequate pain management. ⋯ This multicentre study conducted on a nationwide scale shows that pain relief can be improved in the ED. Pain intensity is not sufficiently reassessed, analgesics are underutilised, morphine sulfate is rarely used and delay in treatment is common. Reasons for inadequate analgesia were identified in order to identify relevant corrective measures to improve quality of pain management in the ED.
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Pediatric emergency care · Feb 2011
Multicenter Study Comparative StudyFamily presence during invasive procedures at the emergency department: what is the opinion of Spanish medical staff?
Family presence (FP) during invasive procedures (IPs) in children remains controversial among pediatric emergency department (PED) staff. The authors aimed to determine health care providers' attitudes toward FP during IPs in Spain, to learn whether parents are given the option of being present during different IPs, and to study which factors influence the providers' opinions. ⋯ The PED staff tend to prefer parents not to be present during IPs as the level of invasiveness increases. Family presence is not common in Spanish PEDs. Older physicians are more likely to support FP than nurses.
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Randomized Controlled Trial Multicenter Study Comparative Study
CLUE: a randomized comparative effectiveness trial of IV nicardipine versus labetalol use in the emergency department.
Our purpose was to compare the safety and efficacy of food and drug administration (FDA) recommended dosing of IV nicardipine versus IV labetalol for the management of acute hypertension. ⋯ Patients treated with nicardipine are more likely to reach the physician-specified SBP target range within 30 minutes than those treated with labetalol.