A Randomized Controlled Noninferiority Trial of Single Dose of Oral Dexamethasone Versus 5 Days of Oral Prednisone in Acute Adult Asthma.

Study Objective: Oral dexamethasone demonstrates bioavailability similar to that of oral prednisone but has a longer half-life. We evaluate whether a single dose of oral dexamethasone plus 4 days of placebo is not inferior to 5 days of oral prednisone in treatment of adults with mild to moderate asthma exacerbations to prevent relapse defined as an unscheduled return visit for additional treatment for persistent or worsening asthma within 14 days.

Methods: Adult emergency department patients (aged 18 to 55 years) were randomized to receive either a single dose of 12 mg of oral dexamethasone with 4 days of placebo or a 5-day course of oral prednisone 60 mg a day.

A Simplified Protocol for the Treatment of Alcohol Withdrawal.

Objectives: The aim of the study was to evaluate a novel simplified tool for symptom-triggered treatment of alcohol withdrawal.

Methods: This retrospective cohort study involved inpatients in a county hospital with an International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis of alcohol withdrawal syndrome (AWS) or delirium tremens between January 1, 2007 and December 31, 2008. The study used the Highland Alcohol Withdrawal Protocol (HAWP)-a simplified derivative of the Revised Clinical Institute Withdrawal Assessment for Alcohol.

Identification of peritonsillar abscess by transcutaneous cervical ultrasound.

Intraoral evaluation with ultrasound has been shown to be an ideal method for differentiating between peritonsillar abscess (PTA) and peritonsillar cellulitis. Unfortunately, many patients experience significant trismus and are unable to tolerate the intracavitary probe. Evaluation of the submandibular space with a high frequency linear transducer from the external aspect of the neck affords an alternative technique that has been shown to have high specificity for PTA.

The ultrasound-guided "peripheral IJ": internal jugular vein catheterization using a standard intravenous catheter.

Background: Obtaining vascular access is difficult in certain patients. When routine peripheral venous catheterization is not possible, several alternatives may be considered, each with its own strengths and limitations.

Discussion: We describe a novel technique for establishing vascular access in Emergency Department (ED) patients: the placement of a standard catheter-over-needle device into the internal jugular vein using real-time ultrasound guidance.