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Emergencies clinical trials

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NCT ID: NCT04288284 Completed - Colorectal Cancer Clinical Trials

Emergency Curative Resection of Colorectal Cancer

Start date: January 2015
Phase:
Study type: Observational

The feasibility and efficacy of emergency curative resection of complicated colorectal cancer is still controversial. This prospective study aim is to assess surgical and oncologic outcomes after emergency compared to elective curative resection of colorectal cancer

NCT ID: NCT04283500 Completed - Opioid-use Disorder Clinical Trials

Buprenorphine Loading in the Emergency Department

Start date: November 1, 2020
Phase: Phase 4
Study type: Interventional

Buprenorphine (BUP) is FDA-approved for the treatment of opioid withdrawal and opioid use disorder. Few ED providers have received the necessary DEA registration (aka X waiver) required to prescribe BUP, and urgent appointments to continue ongoing BUP treatment may not be readily available, thus leading to medication discontinuity. A loading dose induction strategy with 32mg of BUP may help effectively link ED patients to outpatient treatment while minimizing known barriers to ED uptake. Administering a "loading dose" of BUP to saturate mu-opioid receptors would extend the duration of action and provide additional time to secure ongoing treatment. Further, BUP's ceiling effect on respiratory depression makes it a remarkably safe drug even at high doses. In recent years, ED providers have begun to incorporate this approach into clinical protocols, however, it has not been formally studied in this clinical setting. The investigator's study represents the necessary step of studying this novel approach in the ED setting to define the parameters for clinical protocols and large-scale studies.

NCT ID: NCT04281030 Completed - Migraine Clinical Trials

Improving Health Outcomes of Migraine Patients Who Present to the Emergency Department

Start date: June 30, 2019
Phase: N/A
Study type: Interventional

This is a pilot feasibility acceptability study to examine the impact of smartphone-based progressive muscle relaxation (PMR) on migraine quality of life, frequency, intensity, and disability. Feasibility is measured by: a) Proportion of patients who enrolled in the study/were recruited for the study, b) Number of days PMR practiced/week as determined with the backend analytics in the RELAXaHEAD app, c) Minutes/day spent doing PMR, d) Reasons for non-adherence. Acceptability is measured by: a) Satisfaction using Likert scale questions on RELAXaHEAD usability, content, and functionality b) Willingness to repeat a similar treatment intervention in the future (Definitely No/Probably No/Unsure/Probably Yes/ Definitely Yes) c) Attrition. In addition, whether use of electronically based PMR introduced in the emergency department (ED) improves migraine quality of life (MSQv2) and migraine related disability (MIDAS) at 3 months post ED-discharge (or post enrollment date if recruited post ED discharge) compared to those who are not introduced to PMR will be assessed. All participants will be asked to track their headache frequency and intensity using our smartphone application (app) and will be asked to complete migraine quality of life assessments and migraine related disability at follow-up.

NCT ID: NCT04279262 Completed - Clinical trials for Emergency Medical Services

Community First Responders' Role in the Current and Future Rural Health and Care Workforce

Start date: June 1, 2020
Phase:
Study type: Observational

Community First Responders (CFRs) are trained members of the public, lay people or off-duty healthcare staff who volunteer to provide first aid. CFRs help ambulance services to provide care for people having health emergencies, from falls to road accidents to heart attacks, at home or in public places. CFRs are particularly important in rural areas where it is more difficult to provide or access emergency care, and where they are an important part of the care workforce. CFRs are broadly perceived to be positive, however evidence is needed about how they contribute to rural health services, which patients/conditions they attend, what care they provide, how effective they are and at what cost, how they are perceived by patients and other health workers, and how they could be developed to improve care for rural communities. The investigators aim to develop recommendations for rural CFRs, by exploring their contribution to rural care, evaluating their value for money, understanding experiences and views of patients, CFRs and other healthcare staff, and exploring the potential for CFRs to provide new services.

NCT ID: NCT04278807 Completed - Clinical trials for Pain Relief in Proximal Femoral Fracture

PENG-block Versus FIB-block in Emergency Room

Start date: February 14, 2020
Phase: N/A
Study type: Interventional

The trial aims to verify a possible greater analgesic efficacy of PENG (Pericapsular Nerve Group) block compared to iliac fascia block (FIB block) in elderly patients (age > 65 years) suffering from traumatic fracture of proximal femur in emergency room.

NCT ID: NCT04273958 Completed - Pain Clinical Trials

Virtual Reality During Invasive Medical Procedures in an Emergency Department

Start date: February 12, 2020
Phase: N/A
Study type: Interventional

This randomized controlled study aims to investigate whether, during a painful medical procedure in an emergency department (ED), the diffusion of a virtual environment through a virtual reality (VR) headset worn by the patient has a greater impact on the patient's pain and anxiety levels than the diffusion of an identical environment through a computer screen. The study design allows differentiating the impact of the medium from that of the media. The feeling of telepresence of patients in both groups and its association with the impact of the medium will also be investigated. In addition, this study aims to explore whether the wearing of VR headphones is considered comfortable and acceptable by patients.

NCT ID: NCT04266288 Completed - Depression Clinical Trials

Effectiveness of Ketamine for Depression and Suicidal Ideation in the Emergency Department

Start date: October 18, 2019
Phase: Phase 4
Study type: Interventional

The purpose of this study is to examine the effect of a low-dose ketamine infusion on depression symptoms within the Emergency Department (ED) visit, and healthcare utilization after leaving the ED, when administered in the ED for depression or suicidal ideation.

NCT ID: NCT04265066 Completed - Emergencies Clinical Trials

Microcirculation in Prehospital Medicine

MicroCircPreHo
Start date: October 1, 2018
Phase:
Study type: Observational

Diagnostic and risk stratification are limited in emergencies. The measurement of microcirculation might identify patients with poor perfusion but compensated macrocirculation such as in beginning shock. This proof-of-concept study will examine whether sublingual prehospital sidestream dark field microscopy is feasible. This prospective observational study will include patients receiving medical aid by an emergency ambulance who had a spontaneous circulation and offer access to the sublingual mucosa. Sublingual measurement of microcirculation will be performed using a sidestream dark field camera. Video-quality will be evaluated with MIQS (microcirculation image quality score). AVA 4.3C software will calculate microcirculatory parameters.

NCT ID: NCT04261621 Completed - Sepsis Clinical Trials

Early Identification of SEPsis SIGNs in Emergency Department

SepSIGN
Start date: July 6, 2020
Phase:
Study type: Observational

Objective of SepSIGN project is to validate biomarkers able to predict the clinical worsening of patients freshly admitted at Emergency Department. Targeted population is adult patients, freshly admitted at ED, with a suspected or confirmed infection.

NCT ID: NCT04255121 Completed - Emergency Caesarean Clinical Trials

Bicarbonate Epidural Injection in Emergency Caesarian

BiEpIC
Start date: June 22, 2020
Phase: Phase 3
Study type: Interventional

During labor, pain is systematic. In France, epidural analgesia is the gold standard to fight pain. Sometimes, emergency situations involve the maternal or fetal prognosis and require an emergency fetal extraction by caesarean. When an effective epidural analgesia is in place, an injection of adrenaline lidocaine converts this epidural analgesia into an epidural anesthesia allowing a surgical procedure. Sometimes, the time required to set up the anesthesia cannot be expected and a general anesthesia is performed. Local anesthetics used during epidural analgesia have Pka between 7.8 and 8.1. In solution, local anesthetics exist in two forms: an un-ionized form and an ionized form. The non-ionized form is liposoluble and crosses the lipid membranes to reach the site of intracellular action. The non-ionized form conditions the time taken to install anesthesia. When the pH of the solution is equal to Pka, un-ionized and ionized form are present in equal quantity. Commercial local anesthetic solutions have acidic pH and so contained a majority of ionized form. Alkalinization of local anesthetics solution should bring the pH closer to pKa and therefore to favor a greater proportion of non-ionized form.