Annals of emergency medicine
-
Comment Letter Case Reports
Closed thoracic cavity lavage for hypothermia with cardiac arrest.
-
Survival from out-of-hospital cardiac arrest in cities with populations of more than 1 million has not been studied adequately. This study was undertaken to determine the overall survival rate for Chicago and the effect of previously reported variables on survival, and to compare the observed survival rates with those previously reported. ⋯ The overall survival rates were significantly lower than those reported in most previous studies, all based on smaller communities; they were consistent with the rates reported in the one comparable study of a large city. The single factor that most likely contributed to the poor overall survival was the relatively long interval between collapse and defibrillation. Logistical, demographic, and other special characteristics of large cities may have affected the rates. To improve treatment of cardiac arrest in large cities and maximize the use of community resources, we recommend further study of comparable metropolitan areas using standardized terms and methodology. Detailed analysis of each component of the emergency medical services systems will aid in making improvements to maximize survival of out-of-hospital cardiac arrest.
-
Randomized Controlled Trial Clinical Trial
Dose-response evaluation of oral labetalol in patients presenting to the emergency department with accelerated hypertension.
Dose-response evaluation of oral labetalol (100, 200, or 300 mg) on heart rate and systemic blood pressure in emergency department patients with hypertensive urgency (diastolic blood pressure, 110 to 140 mm Hg, and no end-organ evidence of hypertensive emergency). ⋯ Labetalol provides safe and effective treatment for hypertensive urgencies when administered orally in doses of 100 to 300 mg.
-
To determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a major winter event. ⋯ Owing to the low acuity encountered and the availability of Calgary's ALS ambulance service, we concluded that physician-based ALS teams were not required for patient management at the urban venues. Such teams were found to be required at the rural Alpine ski venue. Other reasons for using physicians are discussed, as is development of a standard triage system for mass gatherings.
-
Before the implementation of an intraosseous infusion protocol by the City of Pittsburgh paramedics, we undertook a study to compare the establishment of a simulated intraosseous infusion in three different prehospital settings. The purpose of this study was to determine the time to establish an intraosseous infusion and the success rate at the scene and en route to the hospital using this model. ⋯ Using a simulated model, IO access can be established successfully in the prehospital setting. The minimal time delay in establishing IO infusion may make it an appropriate technique for use at the scene or en route to the hospital.