Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic.

Study Objective: To study the efficacy of intravenous ketorolac, morphine, and both drugs in combination in reducing pain in acute renal colic.

Methods: We conducted a prospective, double-blinded, randomized controlled trial in an urban, teaching emergency department. Patients aged 18 to 55 years and with a clinical diagnosis of acute renal colic and a pain rating greater than 5 on a 10-cm visual analogue scale or at least "moderate pain" on a 4-category verbal pain scale were eligible for inclusion.

Achieving door-to-balloon times that meet quality guidelines: how do successful hospitals do it?

Objectives: We sought to recommend an approach for minimizing preventable delays in door-to-balloon time on the basis of experiences in top-performing hospitals nationally.

Background: Prompt percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) significantly reduces mortality and morbidity; however, door-to-balloon times often exceed the 90-min guideline set forth by the American College of Cardiology (ACC) and the American Heart Association (AHA).

Methods: We conducted a qualitative study using in-depth interviews (n = 122) of hospital staff at hospitals (n = 11) selected as top performers based on data from the National Registry of Myocardial Infarction from January 2001 to December 2002.

The Washington, DC, Youth Curfew: effect on transports of injured youth and homicides.

Objective: Curfews are implemented to curtail youth violence. Trauma systems and emergency medical services (EMS) may need to prepare for changes in patient volume resulting from local ordinances. This study evaluated the impact of the 1995 Washington, DC, Juvenile Curfew Act on EMS transports of injured youth and on youth homicides.

Care and outcome of out-of-hospital deliveries.

Objectives: To identify interventions by paramedics in out-of-hospital deliveries and predictors of neonatal outcome.

Methods: A prospective case series of consecutive out-of-hospital deliveries at Yale-New Haven Hospital from January 1991 to January 1994. Data describing out-of-hospital interventions, demographics, maternal risk factors, and neonatal outcomes were collected from out-of-hospital, emergency department (ED), and hospital records.

Emergency department patients with assault injuries: previous injury and assault convictions.

Study Objective: To compare the incidence of previous assault injury and assault conviction of patients presenting to the ED with assault injuries and the incidence of assault injury and conviction in nonassaulted control patients.

Methods: We conducted a retrospective, medical record-based case-control study of ED patients with assault injuries and matched controls presenting with medical and surgical problems unrelated to assault. The setting was the ED of a 900-bed teaching hospital and Level I trauma center in an urban area.