Here is a look at two articles published in the June issue of Annals of Emergency Medicine. Please visit www.annemergmed.com to read the full text.
Explore This IssueACEP News: Vol 30 – No 06 – June 2011
Erythromycin Infusion and/or Gastric Lavage for Upper Gastrointestinal Bleeding
By D. Pateron et al.
- What is already known on this topic: Erythromycin has pro-motility properties and has been used in the setting of acute upper gastrointestinal bleeding to improve conditions for endoscopy. Nasogastric tube placement with lavage is commonly used for the same indication.
- What question this study addressed: In the setting of acute upper gastrointestinal bleeding, which intervention most frequently provides satisfactory endoscopy conditions: intravenous erythromycin, nasogastric tube with lavage, or both?
- What this study adds to our knowledge: In this 253-patient trial, the frequency of satisfactory endoscopy conditions was similar among groups.
- How this is relevant to clinical practice: In acute upper gastrointestinal bleeding, administration of intravenous erythromycin provides satisfactory endoscopy conditions, potentially obviating the need for a nasogastric tube.
A Randomized Controlled Trial of Self-Management Education for Asthma Patients in the Emergency Department
By C.A. Mancuso et al.
- What is already known on this topic: Many emergency department asthma patients lack self-management skills.
- What question this study addressed: Randomized trial of 296 patients compared 8-week asthma quality of life questionnaire (AQLQ) scores and repeat visits between controls (instruction and peak flow training) vs. intervention (instruction, peak flow training plus workbook, behavioral contract, inhaler training, and telephone reinforcement).
- What this study adds to our knowledge: This particular intervention did not incrementally increase AQLQ scores nor decrease short-term repeat ED visits.
- How this is relevant to clinical practice: Until the optimal components of an education intervention are defined, basic ED asthma instruction and peak flow meter training should be provided.