Abstract:
STUDY OBJECTIVE:We compare metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, with ketorolac 30 mg intravenously in adults with tension-type headache and all nonmigraine, noncluster recurrent headaches. METHODS:In this emergency department (ED)-based randomized, double-blind study, we enrolled adults with nonmigraine, noncluster recurrent headaches. Patients with tension-type headache were a subgroup of special interest. Our primary outcome was a comparison of the improvement in pain score between baseline and 1 hour later, assessed on a 0 to 10 verbal scale. We defined a between-group difference of 2.0 as the minimum clinically significant difference. Secondary endpoints included need for rescue medication in the ED, achieving headache freedom in the ED and sustaining it for 24 hours, and patient's desire to receive the same medication again. RESULTS:We included 120 patients in the analysis. The metoclopramide/diphenhydramine arm improved by a median of 5 (interquartile range 3, 7) scale units, whereas the ketorolac arm improved by a median of 3 (IQR 2, 6) (95% confidence interval [CI] for difference 0 to 3). Metoclopramide+diphenhydramine was superior to ketorolac for all 3 secondary outcomes: the number needed to treat for not requiring ED rescue medication was 3 (95% CI 2 to 6); for sustained headache freedom, 6 (95% CI 3 to 20); and for wish to receive the same medication again, 7 (95% CI 4 to 65). Tension-type headache subgroup results were similar. CONCLUSION:For adults who presented to an ED with tension-type headache or with nonmigraine, noncluster recurrent headache, intravenous metoclopramide+diphenhydramine provided more headache relief than intravenous ketorolac.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Friedman BW,Adewunmi V,Campbell C,Solorzano C,Esses D,Bijur PE,Gallagher EJdoi
10.1016/j.annemergmed.2013.03.017subject
Has Abstractpub_date
2013-10-01 00:00:00pages
311-318.e4issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(13)00251-5journal_volume
62pub_type
杂志文章,随机对照试验abstract:STUDY OBJECTIVE:Ultrasonographically guided intravenous peripheral catheters have dismal dwell time, with most intravenous lines failing before completion of therapy. Catheter length in the vein is directly related to catheter longevity. We investigate the survival of an ultralong ultrasonographically guided intravenou...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2019.11.013
更新日期:2020-08-01 00:00:00
abstract::Paliperidone, or 9-hydroxy risperidone, is the newest atypical antipsychotic agent to be approved for use by the Food and Drug Administration. Despite being the primary active metabolite of risperidone, paliperidone differs in several ways from risperidone. The most notable difference is that paliperidone is formulate...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.10.015
更新日期:2011-07-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. METHODS:We studied a retrospective cohort of injured patients aged 16 years or old...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.04.019
更新日期:2015-01-01 00:00:00
abstract::This clinical policy from the American College of Emergency Physicians addresses key issues in opioid management in adult patients presenting to the emergency department. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical que...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,实务指引
doi:10.1016/j.annemergmed.2020.06.049
更新日期:2020-09-01 00:00:00
abstract:STUDY OBJECTIVE:Studies of travel-related mortality and morbidity have been limited to nonfatal events. Causes of travel-related mortality may differ significantly from morbidity and thus have different prevention strategies. DESIGN:We examined the overseas fatalities of US citizen travelers for the years 1975 and 198...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82379-0
更新日期:1991-06-01 00:00:00
abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80360-3
更新日期:1988-12-01 00:00:00
abstract::Temporary ventricular pacing was successfully employed in two patients suffering refractory bradycardia following traumatic cardiac arrest. The hemodynamic response to pacing was dramatic and both patients eventually recovered fully from an apparent moribund state. Cardiac pacing may be an effective adjuvant in the ea...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80233-2
更新日期:1980-11-01 00:00:00
abstract::Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80296-6
更新日期:1984-08-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN:Prospective, randomized, blinded, cont...
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(95)70260-1
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effectiveness of magnetic resonance imaging in detecting early myocardial infarction in vivo after coronary artery occlusion. DESIGN:A prospective, controlled canine study using a left anterior descending coronary artery ligation model. INTERVENTIONS:After thiopental anesthesia, nine ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81982-1
更新日期:1993-09-01 00:00:00
abstract::Under normal conditions a linear relationship exists between venous and arterial pH values. However, with severe metabolic and hemodynamic stress this correlation has not been established. To evaluate this relationship, nine dogs were subjected to 60 minutes of hemorrhagic shock at a mean arterial pressure of 30 mm Hg...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80127-3
更新日期:1982-06-01 00:00:00
abstract:STUDY PURPOSE:To evaluate the efficacy of adenosine in the treatment of emergency department patients with spontaneous paroxysmal supraventricular tachycardia (PSVT). DESIGN:An eight-month prospective outcome study. POPULATION:Patients 16 or more years old with PSVT by surface ECG criteria. Patients were excluded if ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80829-7
更新日期:1991-07-01 00:00:00
abstract:STUDY OBJECTIVE:This study tests the effect of a brief intervention with emergency department (ED) patients to reduce at-risk drinking. METHODS:We enrolled patients aged 18 years or older who screened positive for at-risk drinking in an urban academic ED and used alternative allocation to assign them to control or int...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2004.10.014
更新日期:2005-07-01 00:00:00
abstract::We report a case of a severe lower gastrointestinal hemorrhage caused by arterioenteric fistula formation in a pancreas transplant patient. A rare but potentially deadly complication of pancreas transplant surgery, arterioenteric fistulas should be considered in every transplant patient presenting with voluminous gast...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/s0196-0644(03)00388-3
更新日期:2003-10-01 00:00:00
abstract:STUDY OBJECTIVES:By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache. DESIGN:The study was conducted over a two-year peri...
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)80201-x
更新日期:1993-02-01 00:00:00
abstract:STUDY PURPOSE:To determine the ability of clinicians to predict the results of emergency head computed tomography (CT) scans. METHODS:Clinicians requesting cranial CT scans from the emergency department prospectively filled out a form detailing their patients' complaints, possible diagnoses, and the likelihood of find...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70351-5
更新日期:1994-06-01 00:00:00
abstract::A 27-year-old man was admitted to the emergency department with a fluphenazine decanoate-induced dystonia. He was treated with 125 mg diphenhydramine IV in four doses and 2 mg benztropine IM. A fluctuating response was observed before continued remission of the dystonia. Possible reasons for variable patient responses...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80077-x
更新日期:1987-06-01 00:00:00
abstract::In rescue medicine, a suction apparatus must function in a variety of environmental conditions. To find an appropriate device for the Swedish Air Force air rescue service the Laerdal suction device 790,000 was selected for further testing according to international standards for aviation safety. Tests showed that vibr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80419-5
更新日期:1987-12-01 00:00:00
abstract::Single-dose antibiotic therapy for urinary tract infections in which no underlying structural or neurologic lesions are present holds the promise of greater patient compliance and convenience. We present the results of a study comparing a single intramuscular dose of a long-acting, third-generation cephalosporin, ceft...
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(85)80239-0
更新日期:1985-10-01 00:00:00
abstract::The traditional use of the American ED, one of unrestricted access by patients and payment for services by insurers, is being questioned in this era of health care reform. Both primary care physicians and managed care organizations have questioned the use of the ED by patients without obvious problems of an emergency ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70164-1
更新日期:1997-09-01 00:00:00
abstract:STUDY OBJECTIVE:We derive a clinical decision rule for ongoing investigation of patients who present to the emergency department (ED) with chest pain. The rule identifies patients who are at low risk of acute coronary syndrome and could be discharged without further cardiac testing. METHODS:This was a prospective obse...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.08.006
更新日期:2016-04-01 00:00:00
abstract::The deleterious effects of night shift work are discussed in relation to emergency physicians. Much of the early research is drawn from heavy industry sources and must be extrapolated to medical work. Disruption of circadian rhythms and Zeitgebers, caused by adherence to contemporary social schedules, causes recurrent...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80615-0
更新日期:1984-03-01 00:00:00
abstract::The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infecti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2012.10.034
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVES:To test the feasibility of using handheld, battery-operated chemical analyzers by EMS personnel in a wilderness environment to aid in the diagnosis and management of heat illness. METHODS:During the summer of 1996, 3 portable clinical analyzers (i-STAT Corp, Princeton, NJ) were kept at different locat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70306-9
更新日期:1999-04-01 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::In a prospective investigation of isolated simple pneumothorax, the treatment of 35 patients with a total of 37 pneumothoraces was studied. A standardized sequential treatment approach was followed for evacuation of the pneumothorax and maintenance of lung reexpansion. The protocol involved catheter placement using a ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80676-0
更新日期:1988-09-01 00:00:00
abstract:STUDY OBJECTIVE:We assessed the independent relationship between age and the quality of medical care provided to patients presenting to the emergency department (ED) with acute myocardial infarction. METHODS:We conducted a 2-year retrospective cohort study of 2,216 acute myocardial infarction patients presenting urgen...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.12.012
更新日期:2005-07-01 00:00:00
abstract::Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The present...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80019-8
更新日期:1989-07-01 00:00:00
abstract::Presented is the case of a 10-year-old child who presented in cardiopulmonary arrest from hypovolemic shock due to pathologic splenic rupture of undetermined etiology. Despite aggressive resuscitation efforts, the patient died. Although rare, pathologic rupture of an abnormal spleen must be considered in the patient w...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80040-1
更新日期:1982-08-01 00:00:00
abstract:STUDY OBJECTIVE:The European Cooperative Acute Stroke Study III (ECASS III) showed that recombinant tissue plasminogen activator (rtPA) administered 3 to 4.5 hours after acute ischemic stroke led to improvement in patient disability versus placebo. We evaluate the long-term incremental cost-effectiveness of rtPA admini...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2012.04.020
更新日期:2013-01-01 00:00:00