Systematic ReviewResearch

PRES in eclampsia or pre-eclampsia was associated with higher liver enzymes and lower platelets

Neurological sciences (PubMed)Sep 10, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review and meta-analysis of patients with eclampsia or pre-eclampsia found that PRES was associated with higher alanine and aspartate aminotransferase levels, lower platelet counts, and higher total bilirubin, but the underlying evidence was highly heterogeneous.

What NurseJet pulled from the source

Across 28 studies, the pooled PRES incidence was 38.68%, but heterogeneity was very high (I²=98.5%). Maternal mortality was numerically higher with PRES but not statistically significant, and stillbirth and preterm birth were not significantly associated.

Why this matters for nurses

PRES is a serious neurologic complication in hypertensive pregnancy disorders; the review highlights associated laboratory and imaging patterns without establishing a diagnostic rule.

Bedside takeaway

Treat laboratory patterns as supportive context, not a diagnostic rule, and escalate neurologic change under local protocol.

Key takeaways

Compared with patients without PRES, mean alanine aminotransferase was 35.88 IU/L higher, mean aspartate aminotransferase was 48.69 IU/L higher, and mean platelet count was 31.15×10⁹/L lower.
The pooled imaging findings most often involved the frontal and temporal lobes.
The authors called for higher-quality prospective studies and standardized prediction models before these factors are used predictively.

Practice implications

Escalate new neurologic changes promptly and trend ordered blood pressure and laboratory assessments within the local pre-eclampsia and eclampsia protocol.

Limitations & cautions

Abstract-only summary. The 28 studies were highly heterogeneous, association does not establish prediction or causation, and the pooled incidence may not generalize across settings or patient severity.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Neurological sciences (PubMed)

Neurological sciences (PubMed). Clinical, Laboratory and Radiological Factors associated with posterior reversible encephalopathy syndrome (PRES) in patients with eclampsia or pre-eclampsia: a systematic review and meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42717136/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Journal of pediatric nursing (PubMed)Oct 23, 2026Research Article

A randomized controlled trial of 140 children aged 3–6 years in a pediatric emergency department found that using a dragon-themed nebulizer mask significantly decreased child fear scores (d = 3.05) and shortened treatment duration compared with standard clear masks.

Peds EmergencyAI summaryReview source

Research ArticleResearchWorkflowQuality ImprovementAI summary · original source linked below

Inhalation therapy is frequently administered for acute respiratory distress in emergency settings, yet standard plastic masks often provoke intense fear and noncooperation in young children, prolonging treatment. In this parallel-group randomized controlled trial conducted between January and March 2026 at a tertiary pediatric emergency department in Istanbul (NCT06568120), 140 preschool children aged 3 to 6 years requiring nebulizer therapy were randomized 1:1 to either a dragon-themed colorful nebulizer mask (n=70) or a standard clear mask control group (n=70). A researcher-nurse recorded procedural metrics using a Demographic Information Form, the Fear Scale, and a Treatment Duration and Adherence Assessment Form. While baseline demographics were comparable (p > 0.05), children in the dragon-themed mask group experienced significantly lower fear scores (p < 0.001, Cohen d = 3.05; 95% CI: 2.56–3.54) and significantly shorter inhalation treatment durations (p = 0.012, Cohen d = 0.47; 95% CI: 0.14–0.81). Observed behavioral distress responses—such as crying, verbal refusal, anger, or mask removal attempts—did not differ significantly between groups (all p > 0.05).

Key takeaways

Parallel-group RCT randomized 140 preschool children aged 3–6 requiring nebulizer therapy in a tertiary pediatric ED to a dragon-themed mask or standard mask.
Children receiving nebulization via the dragon-themed mask demonstrated markedly lower procedural fear scores (p < 0.001, Cohen d = 3.05).
Treatment application duration was significantly reduced in the dragon-themed mask group (p = 0.012, Cohen d = 0.47).
Overt behavioral resistance measures (crying, anger, active mask displacement) were statistically similar between groups (p > 0.05).
Findings support low-cost, child-friendly design adaptations to standard emergency respiratory equipment to diminish pediatric fear and improve workflow.

Why this matters on shift

Pediatric emergency and clinic nurses frequently encounter acute distress, terror, and combative resistance from young children during aerosolized medication delivery. When children scream or fight the mask, drug pulmonary deposition drops sharply and treatment stretches out. Demonstrating that an inexpensive, themed visual mask substantially cuts fear scores and speeds up delivery provides bedside nurses an immediate, non-pharmacological strategy to improve shift efficiency and soothe pediatric patients.

Bedside takeaway

In a 140-child pediatric ED RCT, a dragon-themed nebulizer mask significantly lowered fear scores (d = 3.05) and shortened inhalation duration (p = 0.012) compared to standard masks in children aged 3–6.

Nursing implications

When initiating aerosolized bronchodilator or steroid therapy in preschool-age children, introduce child-friendly themed masks or gamified distraction to alleviate fear; secure an adequate seal around the nose and mouth while reassuring the child and caregiver throughout the nebulization cycle.

Limitations & cautions

Conducted at a single tertiary center in Turkey; open-label delivery precluded blinding of children, caregivers, and administering nurses; overt behavioral distress metrics showed no statistically significant between-group divergence.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of pediatric nursing (PubMed). The effect of using a dragon-themed nebulizer mask on treatment application duration, adherence, and fear in children presenting to the emergency department: A randomized controlled trial.

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Internal and emergency medicine (PubMed)Oct 20, 2026Research Article

A multicenter triple-blind randomized controlled trial of 73 emergency department patients found intravenous ibuprofen (800 mg) produced significantly greater pain score reductions at 10 and 30 minutes and shorter ED stays compared with intravenous ketorolac (30 mg).

Emergency Med-SurgAI summaryReview source

Research ArticleResearchMedication SafetyWorkflowAI summary · original source linked below

Acute low back pain (LBP) accounts for high emergency department utilization, yet clinicians continually seek non-opioid parenteral analgesics that provide rapid, dependable relief without prohibitive adverse profiles. In this multicenter, triple-blind randomized clinical trial conducted across three academic hospital emergency departments, 73 adult patients presenting with acute LBP were randomized to receive either intravenous ibuprofen (800 mg, n=34) or intravenous ketorolac (30 mg, n=39). Analgesic infusions were prepared in quadruplicate blocks by trained head nurses, maintaining blinding for patients, investigators, and biostatisticians. Pain was recorded on a 100-mm Visual Analog Scale (VAS) at baseline, 10 minutes, and 30 minutes post-infusion. Mean VAS pain scores were significantly lower in the ibuprofen arm at 10 minutes (49.6 vs 57.4; p = 0.013) and at 30 minutes (32.2 vs 40.7; p = 0.038). Furthermore, 70.6% of ibuprofen patients achieved mild pain levels by 30 minutes versus 35.9% of ketorolac recipients (p < 0.001). Mean ED length of stay was also significantly shorter in the ibuprofen cohort, while rescue analgesia requirements and drug-related adverse events did not differ between arms.

Key takeaways

Multicenter triple-blind RCT randomized 73 ED patients with acute low back pain to IV ibuprofen 800 mg (n=34) or IV ketorolac 30 mg (n=39).
IV ibuprofen yielded significantly lower VAS pain scores at both 10 minutes (49.6 vs 57.4, p = 0.013) and 30 minutes (32.2 vs 40.7, p = 0.038).
Twice as many patients achieved mild pain intensity at 30 minutes with ibuprofen compared to ketorolac (70.6% vs 35.9%, p < 0.001).
Mean ED length of stay was significantly reduced in the ibuprofen cohort, without any increase in adverse drug events or rescue analgesia.
Findings support IV ibuprofen as an effective, rapid-acting, non-opioid parenteral alternative to ketorolac for acute musculoskeletal back pain in the ED.

Why this matters on shift

Emergency nurses manage acute musculoskeletal back pain daily and frequently administer IV NSAIDs to avoid opioid exposure. Ketorolac has traditionally served as the default parenteral non-opioid, but these triple-blind findings show IV ibuprofen (800 mg) delivers faster and deeper pain reduction within the critical first 30 minutes, doubles the rate of relief down to mild pain, and facilitates earlier discharge without added complications.

Bedside takeaway

In a triple-blind ED RCT of 73 adults with acute low back pain, IV ibuprofen (800 mg) achieved lower VAS pain scores at 10 and 30 minutes and higher mild-pain rates (70.6% vs 35.9%) than IV ketorolac (30 mg).

Nursing implications

Verify renal function, volume status, GI bleeding history, and pregnancy status prior to parenteral NSAID infusion; administer IV ibuprofen over the ordered infusion time and evaluate pain response using a standardized scale at 10 and 30 minutes to determine if rescue analgesia is needed.

Limitations & cautions

Modest total sample size (73 patients) across three university centers; evaluation period concluded at 30 minutes without tracking long-term recurrence or post-discharge outcomes.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Internal and emergency medicine (PubMed). Intravenous ibuprofen versus ketorolac for acute low back pain in the emergency department: a triple-blind randomized clinical trial.

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AI-summarized from the linked source. Review the original article before applying to practice.

Pediatrics (PubMed)Oct 20, 2026Research Article

A randomized crossover simulation trial of 123 emergency clinicians found that real-time device feedback dramatically improved pediatric bag-valve-mask ventilation quality, increasing guideline-adherent tidal volumes from 16.2% to 87.0%.

Peds EmergencyAI summaryReview source

Research ArticleResearchQuality ImprovementPatient EducationAI summary · original source linked below

Manual bag-mask ventilation is a critical, lifesaving intervention for children suffering acute respiratory arrest, but delivery of appropriate pediatric tidal volumes without barotrauma or gastric insufflation remains challenging. In a single-anonymized, randomized crossover trial across five emergency medical services agencies in three US metropolitan areas, 123 emergency clinicians ventilated a high-fidelity manikin simulating a 3-year-old child in respiratory arrest. Participants completed two sequential 2-minute ventilation trials—one with real-time visual feedback using the EOLifeX ventilation feedback device (VFD) and one without feedback—separated by a 10-minute washout period. Real-time feedback increased adherence to age-recommended tidal volumes from 16.2% to 87.0%. Ventilation rate adherence improved from 65.0% to 88.6%, and minimal mask leak (<30%) was maintained in 88.4% of breaths with feedback compared to 80.0% without feedback.

Key takeaways

Randomized crossover simulation study evaluated 123 emergency clinicians ventilating a simulated 3-year-old toddler.
Unassisted baseline ventilation rarely met pediatric standards, with only 16.2% of breaths delivering guideline-recommended tidal volumes.
Real-time visual feedback increased guideline-compliant tidal volume delivery to 87.0% and rate adherence from 65.0% to 88.6%.
Mask seal with less than 30% leak improved from 80.0% to 88.4% when feedback was active.

Why this matters on shift

Pediatric emergency nurses and rapid response teams frequently provide manual ventilation during arrests and severe respiratory compromise. Because children have high chest wall compliance and low functional residual capacity, unguided manual bagging frequently leads to severe hyperventilation or dangerous overdistention. Objective feedback devices provide immediate visual cues that safeguard against excessive tidal volumes and erratic rates.

Bedside takeaway

In a randomized crossover study of 123 emergency clinicians ventilating a 3-year-old child manikin, real-time feedback increased guideline-adherent tidal volume delivery from 16.2% to 87.0% and rate adherence from 65.0% to 88.6%.

Nursing implications

When delivering bag-mask ventilation to pediatric patients, use two-person technique when possible to optimize mask seal, utilize volume-limiting and feedback-guided adjuncts per unit protocol, and maintain deliberate, age-appropriate ventilation rates.

Limitations & cautions

Simulation manikin model evaluating simulated respiratory arrest rather than live clinical patient outcomes; short 2-minute testing intervals may not reflect clinician physical fatigue during prolonged resuscitations.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatrics (PubMed). Prehospital Pediatric Ventilation Quality Following Use of a Feedback Device: A Randomized Study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Randomized trial of 140 preschool children in pediatric ED finds dragon-themed nebulizer mask substantially reduces fear and shortens treatment duration

Triple-blind randomized trial of 73 ED patients finds intravenous ibuprofen achieves superior acute pain relief compared with ketorolac for acute low back pain

Randomized simulation trial of 123 emergency clinicians finds real-time feedback increases pediatric bag-mask ventilation volume compliance from 16% to 87%