Annals of emergency medicine
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To evaluate the safety and effectiveness of the Combitude as used by ICU nurses under medical supervision compared with endotracheal airway established by ICU physicians during CPR. ⋯ The Combitube as used by ICU nurses was as effective as establishment of the endotracheal airway by intensivists during CPR. The Combitube may be used whenever endotracheal intubation cannot be performed immediately.
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To determine the usefulness of sequential nonoperative diagnostic studies in the evaluation and treatment of stable patients after blunt abdominal trauma. ⋯ Diagnostic peritoneal lavage and CT are complementary when evaluating blunt abdominal trauma. Diagnostic peritoneal lavage is an effective screening tool. CT may be reserved for stable patients with a positive diagnostic peritoneal lavage to specify the organs injured. Bleeding often may be treated by embolization, limiting the rate of surgery.
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Comparative Study
Accuracy of bar codes versus handwriting for recording trauma resuscitation events.
To compare the accuracy of computerized bar code data entry with conventional handwritten data entry during videotaped trauma resuscitations. ⋯ Computerized bar code data entry of trauma resuscitation events had significantly fewer entry errors than handwritten data entry in a laboratory setting. Potential advantages of bar code data entry include keyless data entry, automatic time-stamping, standardization of documentation, legibility of the medical record, and "point-of-care" data capture.
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Case Reports
Severe hypernatremic dehydration and hyperkalemia in an infant with gastroenteritis secondary to rotavirus.
A case of severe hypernatremic dehydration (sodium, 191 mmol/L) with associated severe hyperkalemia (potassium, 11.2 mmol/L) and hyperosmolality (502 mOsm/kg) is described in a 3-month-old infant secondary to acute infection with rotavirus. The patient was managed with i.v. fluid resuscitation in conjunction with intracranial pressure monitoring and was discharged well and without any permanent sequelae. Review of the literature reveals the case described to be the most profound example of hypernatremic dehydration with a favorable outcome reported from diarrheal illness. Strategies for management of hypernatremic dehydration are discussed.