JAMA : the journal of the American Medical Association
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The esophageal obturator airway (EOA) has been considered a beneficial ventilatory technique for use in cardiopulmonary resuscitation (CPR). At present, seven studies in the literature compare the EOA with other means of ventilation in humans; only one is an actual field study of its effectiveness. ⋯ There appears to be no current evidence of the EOA's effectiveness for ventilation in prehospital cardiac arrest, and fatal complications have been reported with its use. The use of the EOA to replace endotracheal intubation in airway management is not substantiated in the literature.
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We reviewed 526 medical records of surgical patients and interviewed 81 of these patients. We also sent questionnaires to house staff (57 of 97 responded) and nurses (70 of 142 responded) involved in the care of these patients. ⋯ Physicians prescribed drugs in doses that were often inadequate and to be given at inflexible intervals. The optimal doses and duration of action of meperidine, as judged by the house staff and nurses, did not agree with the accepted pharmacologic profile of this drug.
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Comparative Study
Mortality differences and speed of wound closure among specialized burn care facilities.
Burn patient mortality rates at 11 major American burn care units were investigated and were found to differ substantially after carefully adjusting for patient mix at each participating burn facility. The adjusted mortality rates differed by as much as a factor of two. Institution speed of full-thickness burn wound closure was found to be significantly associated with mortality experience, with lower mortality associated with quicker wound closure. The data analyzed were from the National Burn Information Exchange (12,000 cases).