Abstract：
STUDY OBJECTIVE:To determine whether the use of diclofenac ophthalmic solution is a safe and effective analgesic in the treatment of traumatic corneal abrasions in the emergency department. METHODS:We conducted a prospective, randomized, double-blinded, placebo-controlled clinical trial. Consenting consecutive patients with corneal abrasions who presented to a community-based ED from August through February 1998 were randomly assigned to receive either diclofenac or control vehicle drops. Pain relief was measured using a visual Numeric Pain Intensity Scale (NPIS) before and after treatment. Exclusion criteria were as follows: age younger than 18 years, pregnancy, history of glaucoma, ocular infection, recent eye surgery, other signs of ocular trauma, narcotics within 6 hours, minimal pain (NPIS score <3), and any allergy to diclofenac or nonsteroidal anti-inflammatory drugs. Patients were discharged with study drug or control vehicle solution, a topical antibiotic, oxycodone-acetaminophen as a rescue analgesic, and a pain diary. The outcome measurements were improvement in NPIS score 2 hours after treatment, use of oxycodone-acetaminophen, and occurrence of any adverse effects. RESULTS:Forty-nine patients were enrolled in the study; 25 received diclofenac and 24 received control vehicle drops. Both groups were similar in gender, age, pretreatment pain duration, NPIS score, and analgesic use. There was significantly greater improvement in the 2-hour NPIS score in the diclofenac group (3.1; 95% confidence interval [CI] 2.3 to 4) compared with the control group (1.0; 95% CI 0.1 to 2.0). The difference between the 2 groups was 2.1+/-1.3 (95% CI 0.8 to 3.4). There was a trend toward fewer patients taking rescue oxycodone-acetaminophen in the diclofenac group (20%; 95% CI 4% to 36%) versus the control group (42%; 95% CI 22% to 62%). Other than transient mild stinging, there were no complications associated with diclofenac use. CONCLUSION:Diclofenac ophthalmic solution appears to be a safe and effective analgesic in the treatment of traumatic corneal abrasions in the ED.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Szucs PA,Nashed AH,Allegra JR,Eskin Bdoi
10.1016/s0196-0644(00)70132-6subject
Has Abstractpub_date
2000-02-01 00:00:00pages
131-7issue
2eissn
0196-0644issn
1097-6760pii
S0196064400857637journal_volume
35pub_type
临床试验,杂志文章,随机对照试验abstract：STUDY OBJECTIVE:To study early microcirculatory perfusion indices in patients with severe sepsis/septic shock, compare early microcirculatory indices in sepsis survivors versus nonsurvivors, and identify systemic hemodynamic/oxygen transport variables that correlate with early microcirculatory perfusion indices. METHO...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.08.021
更新日期：2007-01-01 00:00:00
abstract：:A profoundly hypothermic 5-hour-old infant in cardiac arrest was brought to the emergency department by paramedics. The infant was found wrapped in a garbage bag inside a freezer. She had been in the freezer for approximately four hours. Her initial rectal temperature was 16.2 degrees C. Active external and core warmi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(94)70369-8
更新日期：1994-06-01 00:00:00
abstract：STUDY OBJECTIVES:To determine the availability and use of premixed activated charcoal in sorbitol preparations during multiple-dose activated charcoal therapy in the emergency department. DESIGN AND SETTING:A prospective telephone survey of all 911 receiving hospitals within the catchment area of one poison center. T...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80406-8
更新日期：1993-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether reminder signs placed at the exits to parking decks increase the rate of safety belt use. METHODS:The subjects in this study were drivers of automobiles with permits to park in campus decks at a major university. Volunteer observers were positioned near the exits of 5 parking decks...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2000.111059
更新日期：2000-12-01 00:00:00
abstract：:Hemodynamically unstable patients will benefit from therapy to control their blood pressure only if this pressure can be determined with accuracy. We compared the accuracy of arterial blood pressure measurements taken aboard helicopters by palpation with a Doppler device and with an oscillometric device. Twenty critic...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(88)80401-3
更新日期：1988-06-01 00:00:00
abstract：:Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan w...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80464-8
更新日期：1983-06-01 00:00:00
abstract：:Although health care rapidly adopts technologic advances from other fields, it has been slow to incorporate well-established principles from human factors engineering into the health care workplace. This article demonstrates some of those principles by analyzing an all too routine clinical event from a human factors p...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.124900
更新日期：2002-08-01 00:00:00
abstract：:We report the cases of three patients with residual symptoms from diving decompression sickness, each of whom presented to a recompression chamber three to seven days following original exposure. All three had complete resolution of symptomatology despite the delayed treatment. The late resolution of symptoms is evide...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80450-9
更新日期：1985-03-01 00:00:00
abstract：:Recent investigations suggest that increased intrathoracic pressure causing compression of the heart and great vessels in the thorax plays an important role in providing blood flow during cardiopulmonary resuscitation. This communication reports the case of a four-year-old asphyxiated girl found to have a small amount...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80474-4
更新日期：1980-12-01 00:00:00
abstract：:Colloid cyst of the third ventricle, although a benign lesion, carries with it high mortality and morbidity if not diagnosed in time. The most common presenting symptom is headache. A 31-year-old man with a history of intermittent, throbbing, unilateral headache and nausea was admitted because of exacerbation of his h...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(83)80260-1
更新日期：1983-12-01 00:00:00
abstract：:One hundred twenty-five pediatric emergency department patients were studied prospectively to determine whether any findings on the physical examination were predictive of abnormalities seen on chest radiograph. We attempted to find possible correlations between such clinical examination findings, recorded prior to ra...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80374-2
更新日期：1986-07-01 00:00:00
abstract：STUDY OBJECTIVE:We aim to evaluate the accuracy of the broad-range 16S polymerase chain reaction test in the diagnosis of bacterial meningitis through a systematic review and meta-analysis. METHODS:We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Registry, using the Medical Subject Headings terms "polym...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.annemergmed.2012.05.040
更新日期：2012-11-01 00:00:00
abstract：STUDY OBJECTIVE:The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2016.10.007
更新日期：2017-04-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies suggest improved patient outcomes for providers who perform high volumes of complex medical procedures. Out-of-hospital tracheal intubation is a difficult procedure. We seek to determine the association between rescuer procedural experience and patient survival after out-of-hospital tra...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.12.020
更新日期：2010-06-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.02.022
更新日期：2018-07-01 00:00:00
abstract：:Early reports of "reperfusion arrhythmia" after experimental temporary coronary occlusion raised concern that these arrhythmias, particularly ventricular fibrillation and ventricular tachycardia, might occur in association with reperfusion of an occluded coronary vessel during thrombolysis. Such an occurrence could in...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80404-4
更新日期：1989-03-01 00:00:00
abstract：STUDY OBJECTIVE:Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2007.11.019
更新日期：2008-04-01 00:00:00
abstract：:Descriptive statistics include measures of central tendency and variability. Measures of central tendency include mean, median, and mode. The mean is the arithmetic average of data from interval or ratio scales. The median reflects the 50th percentile score. The mode is the most frequently occurring value of a data di...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82052-9
更新日期：1990-03-01 00:00:00
abstract：:A comparison of several maneuvers that are believed to increase vagal tone was made by measuring the carotid sinus with an ultrasound device. For 20 healthy volunteers the mean carotid sinus diameter was 5.7 mm supine, 6.1 mm in the Trendelenberg position, 6.5 mm after supine medical antishock trousers (MAST) inflatio...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80921-5
更新日期：1985-11-01 00:00:00
abstract：:TSS is a recently described acute febrile illness characterized by hypotension, rash, desquamation, and multisystemic involvement. While most common in menstruating women, TSS also occurs in men and non-menstruating women. It is now known that the disease is caused by one or more toxins produced by the S aureus organi...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(88)80121-5
更新日期：1988-03-01 00:00:00
abstract：:Acid-base changes occurring during cardiac arrest and subsequent CPR are related to a complex low-perfusion state characterized clinically by venous and tissue hypercarbic and metabolic (lactic) acidosis. This low-flow state is a dynamic process dependent on the time intervals between onset of arrest, initiation of CP...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(05)80471-8
更新日期：1993-02-01 00:00:00
abstract：:We compared the abilities of the Trauma Score (TS), the Revised Trauma Score (RTS), and the Pediatric Trauma Score (PTS) to retrospectively identify severely injured children. TS, RTS, and PTS were computed on admission for 1,334 consecutive blunt and penetrating trauma victims 0 to 14 years old. Injury Severity Score...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80930-8
更新日期：1989-10-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(96)70112-9
更新日期：1996-11-01 00:00:00
abstract：:Although all emergency physicians are familiar with catastrophic causes of free intraperitoneal air, we describe the case of a healthy 26-year-old woman who presented to our emergency department (ED) with a nonsurgical and previously unreported cause of pneumoperitoneum. The patient presented to our ED with complaints...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2015.02.011
更新日期：2015-08-01 00:00:00
abstract：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 dia...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.annemergmed.2006.03.013
更新日期：2006-08-01 00:00:00
abstract：:We report an unusual presentation of solvent abuse. A 17-year-old boy was brought to the emergency department after he inhaled fumes from a rag soaked with a carburetor cleaner containing toluene, methylene chloride, and methanol. Considered to be intoxicated from the acute effects of sniffing toluene or methylene chl...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82467-9
更新日期：1990-06-01 00:00:00
abstract：:Our study was conducted to determine the appropriate dose of lidocaine using the larynx and to characterize the onset and duration of therapeutic serum levels. A mean dose of 5.67 +/- 1.2 mg/kg was topically administered to the subglottic region of seven comatose patients through a cricothyroid membrane puncture. Seri...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(82)80062-0
更新日期：1982-09-01 00:00:00
abstract：:It is common practice to soak acute traumatic wounds in dilute povidone-iodine solution before definitive wound cleaning and debridement. The effectiveness of soaking wounds is unknown. Using quantitative wound bacterial counts as a measure of efficacy, we compared wounds soaked in 1% povidone-iodine solution or in no...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0196-0644(05)82486-2
更新日期：1990-06-01 00:00:00
abstract：:Sodium metabisulfite (MBS) is a commonly used food and drug preservative. We report the case of a 32-year-old man with a documented history of allergy to MBS who developed an anaphylactic reaction after ingestion of MBS-treated foods. The patient had a prolonged clinical course requiring two emergency department visit...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(86)80492-9
更新日期：1986-01-01 00:00:00
abstract：STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...
journal_title：Annals of emergency medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0196-0644(97)70105-7
更新日期：1997-07-01 00:00:00
