Risk-stratification tools for emergency department patients with syncope: A systematic review and meta-analysis of direct evidence for SAEM GRACE.

Objectives: Approximately 10% of patients with syncope have serious or life-threatening causes that may not be apparent during the initial emergency department (ED) assessment. Consequently, researchers have developed clinical decision rules (CDRs) to predict adverse outcomes and risk stratify ED syncope patients. This systematic review and meta-analysis (SRMA) aims to cohere and synthesize the best current evidence regarding the methodological quality and predictive accuracy of CDRs for developing an evidence-based ED syncope management guideline.

Using Children's Artwork to Improve Adherence with Timely Antibiotic Administration in Open Fractures.

Introduction: Antibiotics for open fractures (OFs) administered within 60 min of emergency department (ED) arrival reduce patients' infection risk. We tested a novel method of displaying children's drawings to prompt clinicians to improve adherence with early antibiotics for OFs.

Methods: Registry-based pre- (January 1, 2016-June 30, 2019) and post- (July 1, 2019-March 31, 2022) intervention at a level 1 trauma center.

Lidocaine patch for treatment of acute localized pain in the emergency department: a systematic review and meta-analysis.

Lidocaine patches are commonly prescribed for acute localized pain. Most of the existing evidence is, however, derived from postoperative or chronic pain. The objective of this study is to assess the efficacy and safety of lidocaine patch compared to placebo patch or nonsteroidal anti-inflammatory drugs (NSAIDs) for acute localized pain.

Interventions to improve emergency department throughput and care delivery indicators: A systematic review and meta-analysis.

Background: Emergency department (ED) crowding has repercussions on acute care, contributing to prolonged wait times, length of stay, and left without being seen (LWBS). These indicators are regarded as systemic shortcomings, reflecting a failure to provide equitable and accessible acute care. The objective was to evaluate the effectiveness of interventions aimed at improving ED care delivery indicators.

Why ketamine.

We present the rationale for testing ketamine as an add-on therapy for treating benzodiazepine refractory (established) status epilepticus. In animal studies, ketamine terminates benzodiazepine refractory status epilepticus by interfering with the pathophysiological mechanisms and is a neuroprotectant. Ketamine does not suppress respiration when used for sedation and anesthesia.

Non-invasive positive pressure ventilation versus endotracheal intubation in treatment of COVID-19 patients requiring ventilatory support.

Importance: Initial guidelines recommended prompt endotracheal intubation rather than non-invasive ventilation (NIV) for COVID-19 patients requiring ventilator support. There is insufficient data comparing the impact of intubation versus NIV on patient-centered outcomes of these patients.

Objective: To compare all-cause 30-day mortality for hospitalized COVID-19 patients with respiratory failure who underwent intubation first, intubation after NIV, or NIV only.

Real-time audio-visual feedback with handheld nonautomated external defibrillator devices during cardiopulmonary resuscitation for in-hospital cardiac arrest: A meta-analysis.

Objective: Restoring cardiopulmonary circulation with effective chest compression remains the cornerstone of resuscitation, yet real-time compressions may be suboptimal. This project aims to determine whether in patients with in-hospital cardiac arrest (IHCA; population), chest compressions performed with free-standing audiovisual feedback (AVF) device as compared to standard manual chest compression (comparison) results in improved outcomes, including the sustained return of spontaneous circulation (ROSC), and survival to the intensive care unit (ICU) and hospital discharge (outcomes).

Methods: Scholarly databases and relevant bibliographies were searched, as were clinical trial registries and relevant conference proceedings to limit publication bias.

Electroencephalographic Seizures in Emergency Department Patients After Treatment for Convulsive Status Epilepticus.

Purpose: It is unknown how often and how early EEG is obtained in patients presenting with status epilepticus. The Established Status Epilepticus Treatment Trial enrolled patients with benzodiazepine-refractory seizures and randomized participants to fosphenytoin, levetiracetam, or valproate. The use of early EEG, including frequency of electrographic seizures, was determined in Established Status Epilepticus Treatment Trial participants.

Intravenous Amide Anesthetics to Treat Pain Associated with Renal Colic in the Emergency Department: a Systematic Review.

Introduction: Renal colic affects 12% of the U.S. population, accounting for nearly 1% of emergency department (ED) visits.

Intravenous Magnesium Sulfate to Treat Acute Headaches in the Emergency Department: A Systematic Review.

Introduction: Non-traumatic headaches comprise up to 4% of all emergency department (ED) visits. Current practice is moving toward multimodal analgesia regimens that limit narcotic use.

Objective: The objective of this systematic review is to address the following research question: In patients with non-traumatic headaches (Population), does administration of intravenous magnesium sulfate (Intervention) compared to placebo, corticosteroids, dopamine antagonists, ergot alkaloids, non-steroidal anti-inflammatory drugs (NSAIDs), triptans, or usual care result in better pain control, lower rate of recurrence at 24 hours, lower requirements for rescue analgesia, and less adverse medication effects (Outcomes)?

Methods: Scholarly databases and relevant bibliographies were searched, as were clinical trial registries and relevant conference proceedings to limit publication bias.

Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module.

Background: Approximately 5% of emergency department (ED) patients with altered mental status (AMS) have non-convulsive seizures (NCS). Patients with NCS should be diagnosed with EEG as soon as possible to initiate antiepileptic treatment. Since ED physicians encounter such patients first in the ED, they should be familiar with general EEG principles as well as the EEG patterns of NCS/NCSE.

A systematic review of foam dressings for partial thickness burns.

Background: Partial thickness burns are the most common form of thermal burns. Traditionally, dressing for these burns is simple gauze with silver sulfadiazine (SSD) changed on a daily basis. Foam dressings have been proposed to offer the advantage of requiring less frequent dressing change and better absorption of exudates.

Neuroleptanalgesia for acute abdominal pain: a systematic review.

Background: Acute abdominal pain (AAP) comprises up to 10% of all emergency department (ED) visits. Current pain management practice is moving toward multi-modal analgesia regimens that decrease opioid use.

Objective: This project sought to determine whether, in patients with AAP (population), does administration of butyrophenone antipsychotics (intervention) compared to placebo, usual care, or opiates alone (comparisons) improve analgesia or decrease opiate consumption (outcomes)?

Methods: A structured search was performed in Cochrane CENTRAL, CINAHL, Database of Abstracts of Reviews of Effects, Directory of Open Access Journals, Embase, IEEE-Xplorer, Latin American and Caribbean Health Sciences Literature, Magiran, PubMed, Scientific Information Database, Scopus, TÜBİTAK ULAKBİM, and Web of Science.