The effect of aromatherapy with peppermint essential oil on anxiety of cardiac patients in emergency department: A placebo-controlled study

Background: Treatment provided in an emergency department is aimed at alleviating pain immediately with minimized adverse effects as well as warding off further migraine attacks. The primary aim of this article is to compare the effectiveness of oral paracetamol versus zolmitriptan in treating acute migraine attacks. Methods: This prospective, randomized, and controlled study was carried out at a tertiary care hospital visited by 95,000 patients annually. The study recruited 200 participants who were randomized into two groups. One group received 1000 mg paracetamol while the other group received 2.5 mg zolmitriptan orally. Baseline pain scores were recorded using the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 15, 30 and at 60 min following administration of the study drugs. Patients requiring further treatment were provided fentanyl at a dosage of 1 µg/kg as a rescue therapy. Results: A significant decrease was evident in VAS and NRS scores following the administration of the study drugs in both groups (P < 0.001). The change in VAS pain scores after 15, 30 and 60 min was calculated as 17.0 ± 13.9, 41.2 ± 16.3 and 61.2 ± 17.5 mm, respectively, in the paracetamol group and 14.2 ± 11.7, 39.2 ± 17.9 and 59.2± 19.3 mm, respectively, in the zolmitriptan group, which did not indicate significant differences (P = 0.103, P = 0.425, P = 0.483, respectively). Likewise, NRS pain scores showed a downward trend in line with VAS pain scores and did not yield a significant difference (P = 0.422). No significant difference concerning rescue therapy was noted between the two groups (P = 0.596). Conclusion: Oral paracetamol and zolmitriptan prove to be similarly effective and have low incidence of acute side effects in treating acute migraine cases without aura.

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Amethocaine versus EMLA for successful intravenous cannulation in a children's emergency department: a randomised controlled study

Emergency Medicine Journal ◽

10.1136/emj.2008.065110 ◽

2009 ◽

Vol 26 (7) ◽

pp. 487-491 ◽

Cited By ~ 13

Author(s):

C Newbury ◽

D W Herd

Keyword(s):

Emergency Department ◽

Controlled Study ◽

Randomised Controlled Study ◽

Randomised Controlled

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Cardiac Patients at End of Life in the Emergency Department

End-of-Life Care in Cardiovascular Disease ◽

10.1007/978-1-4471-6521-7_6 ◽

2014 ◽

pp. 91-105

Author(s):

Derrick Lowery ◽

Christopher R. Carpenter

Keyword(s):

Emergency Department ◽

End Of Life ◽

Cardiac Patients

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Abstract WP245: Hyperacute Blood Pressure Variability is Associated with Early Neurological Deterioration

Stroke ◽

10.1161/str.48.suppl_1.wp245 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Joseph Kim ◽

Jeffrey L Saver ◽

David S Liebeskind ◽

Sidney Starkman ◽

Scott Hamilton ◽

...

Keyword(s):

Blood Pressure ◽

Emergency Department ◽

Cerebral Ischemia ◽

Acute Stroke ◽

Symptom Onset ◽

Blood Pressure Variability ◽

Final Diagnosis ◽

Controlled Study ◽

Double Blind ◽

Neurologic Deterioration

Background: Increased blood pressure variability (BPV) has been associated with worse outcomes in acute stroke. The effect of hyperacute (<4 hours) BPV on early neurologic deterioration (END) has not been described. Objective: To investigate whether BPV in the first hours after stroke onset is associated with END from prehospital evaluation to presentation at the emergency department Methods: All patients enrolled in the NIH Field Administration of Stroke Therapy-Magnesium (FAST-MAG) phase 3 trial were included. FAST-MAG was a multicenter, randomized, double-blind, placebo-controlled study looking at whether initiation of magnesium sulfate (20 grams/24 hours) in the prehospital setting of acute stroke would reduce disability. Study agent was initiated prior to hospital arrival < 2 hours from symptom onset. BPV was defined as the standard deviation of systolic blood pressure of all readings obtained by 4 hours after initiation of study agent. END was diagnosed as Glasgow Coma Scale (GCS) decrease by ≥ 2 points between the prehospital evaluation and post-emergency department arrival assessment by a study nurse. Results: There were 1,700 cases evaluated by paramedics 24 minutes (15-45 IQR), and by study nurses 150 minutes (120-180) after symptom onset with a median of 6 (IQR 5-6) BP readings. The mean (±SD) age was 69±13 years, 42.6% were women, and the median prehospital GCS was 15 (IQR 14-15). The final diagnosis was cerebral ischemia in 73.3% of patients, intracranial hemorrhage in 22.8%, and a stroke-mimicking condition in 3.9%. END was seen in 202 (12%) of subjects, with higher rates noted in those with intracerebral hemorrhage (ICH) compared to cerebral ischemia (31% vs 6%). Overall, there was greater BPV in patients with END (23mmHg vs 15mmHg, p<0.001). Blood pressure variability was greater in cases of cerebral ischemia with END (N=1,245, 18mmHg vs 15mmHg, p=0.004) and in ICH cases with END (N=387, 23mmHg vs 15mmHg, p<0.001). Conclusion: Greater blood pressure variability is associated with early neurologic deterioration in patients with cerebral ischemia and ICH evaluated <2 hours from symptom onset.

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Brief Cognitive‐based Psychosocial Intervention and Case Management for Suicide Attempters Discharged from the Emergency Department in Taipei, Taiwan: A Randomized Controlled Study

Suicide and Life-Threatening Behavior ◽

10.1111/sltb.12626 ◽

2020 ◽

Vol 50 (3) ◽

pp. 688-705

Author(s):

Yi‐Chun Lin ◽

Shen‐Ing Liu ◽

Shu‐Chin Chen ◽

Fang‐Ju Sun ◽

Hui‐Chun Huang ◽

...

Keyword(s):

Emergency Department ◽

Case Management ◽

Psychosocial Intervention ◽

Randomized Controlled Study ◽

Controlled Study ◽

Suicide Attempters ◽

Randomized Controlled

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A Double-Blind Comparison of Granisetron and Placebo for the Treatment of Acute Migraine in The Emergency Department

Cephalalgia ◽

10.1046/j.1468-2982.1991.1105207.x ◽

1991 ◽

Vol 11 (5) ◽

pp. 207-213 ◽

Cited By ~ 21

Author(s):

Bruce MT Rowat ◽

Charles F Merrill ◽

Alan Davis ◽

Valerie South

Keyword(s):

Emergency Department ◽

Controlled Study ◽

Acute Migraine ◽

Eligibility Criteria ◽

Double Blind ◽

Post Infusion ◽

Affective Components ◽

Headache Pain ◽

Blind Comparison ◽

Categorical Scale

Three hundred and ninety-seven patients who presented to the emergency department were screened for a randomized, double-blind, placebo-controlled study of iv granisetron (40 μg/kg or 80 μg/kg) in acute migraine. Twenty-eight patients fulfilled the stringent eligibility criteria and completed the study. Rescue medication was required 2 h post-infusion in 8 of 10 patients receiving granisetron 40 μg/kg, 5 of 10 patients receiving granisetron 80 μg/kg, and 6 of 8 patients receiving placebo. Significant improvement (p < 0.05) in headache pain (on a visual analogue scale and categorical scale) was observed in the 80–μg/kg group. Headache pain evaluated with the Hunter headache scale indicated improvement for the sensory and affective components of headache pain in both granisetron groups. Except for more nausea at 30 min in the placebo group, no significant differences were noted between treatments. All three treatments were well tolerated. Granisetron may be effective for acute migraine headache; however, further studies with increased patient numbers are required.

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