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<< An Evidence-Based Approach To Traumatic Pain Management In The Emergency Department (Trauma CME)


Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study will be included in bold type following the reference, where available. In addition, the most informative references cited in this paper, as determined by the authors, are noted by an asterisk (*) next to the number of the reference.

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  10. * Thomas S, ed. Emergency Department Analgesia. New York: Cambridge University Press; 2008. (Textbook)
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  12. * Fink WA Jr. The pathophysiology of acute pain. Emerg Med Clin North Am. 2005;23(2):277-284. (Review)
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  57. Suraseranivongse S, Santawat U, Kraiprasit K, et al. Cross-validation of a composite pain scale for preschool children within 24 hours of surgery. Br J Anaesth. 2001;87(3):400-405. (Cross-validation; 167 pediatric patients)
  58. Merkel S, Voepel-Lewis T, Shayevitz J, et al. The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-297. (Observational; 89 children)
  59. McGrath PA, Seifert CE, Speechley KN, et al. A new analogue scale for assessing children’s pain: an initial validation study. Pain. 1996;64(3):435-443. (Comparison; 104 patients)
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  63. Noble VE, Liteplo AS, Nelson BP, et al. The impact of analgesia on the diagnostic accuracy of the sonographic Murphy’s sign. Eur J Emerg Med. 2010;17(2):80-83. (Randomized double-blind placebo-controlled; 30 patients)
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  69. Giannoudis PV, MacDonald DA, Matthews SJ, et al. Nonunion of the femoral diaphysis. The influence of reaming and non-steroidal anti-inflammatory drugs. J Bone Joint Surg Br. 2000;82(5):655-658. (Retrospective; 377 patients)
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  71. Hinz B, Cheremina O, Brune K. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J. 2008;22(2):383-390. (Clinical trial; 5 human volunteers)
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  74. Bisanzo M, Nichols K, Hammerstedt H, et al. Nurse-administered ketamine sedation in an emergency department in rural Uganda. Ann Emerg Med. 2012;59(4):268-275. (Observational; 191 patients)
  75. Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006;18(1):37-44. (Systematic review)
  76. Albanese J, Arnaud S, Rey M, et al. Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation. Anesthesiology. 1997;87(6):1328-1334. (Prospective; 8 patients)
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