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Emdoctor's Essays

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6 papers 0 to 25 followers
By Andrew Jenis I'm a Troubleshooter
https://www.readbyqxmd.com/read/18565859/rhythm-control-versus-rate-control-for-atrial-fibrillation-and-heart-failure
#1
RANDOMIZED CONTROLLED TRIAL
Denis Roy, Mario Talajic, Stanley Nattel, D George Wyse, Paul Dorian, Kerry L Lee, Martial G Bourassa, J Malcolm O Arnold, Alfred E Buxton, A John Camm, Stuart J Connolly, Marc Dubuc, Anique Ducharme, Peter G Guerra, Stefan H Hohnloser, Jean Lambert, Jean-Yves Le Heuzey, Gilles O'Hara, Ole Dyg Pedersen, Jean-Lucien Rouleau, Bramah N Singh, Lynne Warner Stevenson, William G Stevenson, Bernard Thibault, Albert L Waldo
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure and suggesting that the suppression of atrial fibrillation may favorably affect the outcome. However, the benefits and risks of this approach have not been adequately studied. METHODS: We conducted a multicenter, randomized trial comparing the maintenance of sinus rhythm (rhythm control) with control of the ventricular rate (rate control) in patients with a left ventricular ejection fraction of 35% or less, symptoms of congestive heart failure, and a history of atrial fibrillation...
June 19, 2008: New England Journal of Medicine
https://www.readbyqxmd.com/read/24637134/an-ed-scribe-program-is-able-to-improve-throughput-time-and-patient-satisfaction
#2
Aveh Bastani, Blerina Shaqiri, Kristen Palomba, Dominic Bananno, William Anderson
INTRODUCTION: At our institution, we previously described the detrimental effect of computerized physician order entry (CPOE) on throughput time and patient satisfaction (Ann of Emer Med, Vol 56, P S83-S84). To address these quality metrics, we conducted a pilot program using scribes in the emergency department (ED). METHODS: We conducted a before-and-after study of ED throughput at our 320-bed suburban community hospital with a census of 70000 annual visits. Our primary outcome measure was the effect of scribes on ED throughput as measured by the effect on (1) door-to-room time; (2) room-to-doc time; (3) door-to-doc time; (4) doc-to-dispo time; and (5) length of stay for discharged/admitted patients, between pre-CPOE and post-CPOE cohorts...
May 2014: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24635773/a-randomized-trial-of-protocol-based-care-for-early-septic-shock
#3
RANDOMIZED CONTROLLED TRIAL
Donald M Yealy, John A Kellum, David T Huang, Amber E Barnato, Lisa A Weissfeld, Francis Pike, Thomas Terndrup, Henry E Wang, Peter C Hou, Frank LoVecchio, Michael R Filbin, Nathan I Shapiro, Derek C Angus
BACKGROUND: In a single-center study published more than a decade ago involving patients presenting to the emergency department with severe sepsis and septic shock, mortality was markedly lower among those who were treated according to a 6-hour protocol of early goal-directed therapy (EGDT), in which intravenous fluids, vasopressors, inotropes, and blood transfusions were adjusted to reach central hemodynamic targets, than among those receiving usual care. We conducted a trial to determine whether these findings were generalizable and whether all aspects of the protocol were necessary...
May 1, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/22290281/randomized-clinical-trial-of-antibiotics-in-acute-uncomplicated-diverticulitis
#4
RANDOMIZED CONTROLLED TRIAL
A Chabok, L PĂ„hlman, F Hjern, S Haapaniemi, K Smedh
BACKGROUND: The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need for antibiotic treatment in acute uncomplicated diverticulitis, with the endpoint of recovery without complications after 12 months of follow-up. METHODS: This multicentre randomized trial involving ten surgical departments in Sweden and one in Iceland recruited 623 patients with computed tomography-verified acute uncomplicated left-sided diverticulitis...
April 2012: British Journal of Surgery
https://www.readbyqxmd.com/read/19439742/epinephrine-and-dexamethasone-in-children-with-bronchiolitis
#5
RANDOMIZED CONTROLLED TRIAL
Amy C Plint, David W Johnson, Hema Patel, Natasha Wiebe, Rhonda Correll, Rollin Brant, Craig Mitton, Serge Gouin, Maala Bhatt, Gary Joubert, Karen J L Black, Troy Turner, Sandra Whitehouse, Terry P Klassen et al.
BACKGROUND: Although numerous studies have explored the benefit of using nebulized epinephrine or corticosteroids alone to treat infants with bronchiolitis, the effectiveness of combining these medications is not well established. METHODS: We conducted a multicenter, double-blind, placebo-controlled trial in which 800 infants (6 weeks to 12 months of age) with bronchiolitis who were seen in the pediatric emergency department were randomly assigned to one of four study groups...
May 14, 2009: New England Journal of Medicine
https://www.readbyqxmd.com/read/24628747/randomized-clinical-trial-of-hydrocodone-acetaminophen-versus-codeine-acetaminophen-in-the-treatment-of-acute-extremity-pain-after-emergency-department-discharge
#6
RANDOMIZED CONTROLLED TRIAL
Andrew K Chang, Polly E Bijur, Kevin G Munjal, E John Gallagher
OBJECTIVES: The objective was to test the hypothesis that hydrocodone/acetaminophen (Vicodin [5/500]) provides more efficacious analgesia than codeine/acetaminophen (Tylenol #3 [30/300]) in patients discharged from the emergency department (ED). Both are currently Drug Enforcement Administration (DEA) Schedule III narcotics. METHODS: This was a prospective, randomized, double-blind, clinical trial of patients with acute extremity pain who were discharged home from the ED, comparing a 3-day supply of oral hydrocodone/acetaminophen (5 mg/500 mg) to oral codeine/acetaminophen (30 mg/300 mg)...
March 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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