Annals of emergency medicine
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Comparative Study
Comparison of standard external CPR, open-chest CPR, and cardiopulmonary bypass in a canine myocardial infarct model.
After cardiac arrest, open-chest CPR (OCCPR) and cardiopulmonary bypass (CPB) have demonstrated higher resuscitation rates when compared individually with standard external CPR (SECPR). We compared all three techniques in a canine myocardial infarct ventricular fibrillation model. ⋯ OCCPR and CPB produce higher coronary perfusion pressures and improved resuscitation rates from ventricular fibrillation when compared with SECPR in this canine myocardial infarct cardiac arrest model. CPB and OCCPR yielded similar resuscitation results, although less epinephrine was required with CPB.
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The purpose of this study was to obtain information about how patients perceive the health care delivered in an emergency department. ⋯ The information given to patients on arrival at the ED may be important to a positive perception of the care given during their stay.
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Case Reports
Snake venom coagulopathy: use and abuse of blood products in the treatment of pit viper envenomation.
Coagulopathies are commonly encountered in victims of pit viper envenomation. In the majority of patients these defects improve with administration of antivenin. ⋯ This article documents the effectiveness and risks of antivenin administration and the risks of blood product transfusion. We recommend that blood products not be used except for clearly defined clinical indications.
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Comparative Study
Intraosseous administration of antibiotics: same-dose comparison with intravenous administration in the weanling pig.
To assess the reliability of the intraosseous route of administration for delivery of a loading dose of broad-spectrum antibiotics in a pediatric animal model. ⋯ In the weanling pig model, the IO route was used to deliver serum levels of broad-spectrum antibiotics comparable to those attained after IV administration. The data support the use of standard parenteral doses for IO administration. To overcome potential avid protein binding of ceftriaxone in the bone marrow, we recommend using ceftriaxone at its highest recommended IO loading dose. Consistent with many other medications that have been similarly tested, these data indicate that initial or empiric antibiotic coverage in hypodynamic and shock states in infants and young children need not await the establishment of traditional IV access.
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Comparative Study
An analysis of emergency department use by patients with minor illness.
To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. ⋯ There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.