Annals of emergency medicine
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Dismal survival in patients receiving standard manual CPR provided the rationale for the investigation of alternate methods of closed-chest circulatory support. Active compression-decompression (ACD) and high-impulse CPR are alternatives to standard manual CPR. This study was designed to test the hypothesis that ACD CPR provides superior cardiopulmonary hemodynamics due to an active decompression phase when compared with high-impulse manual CPR. ⋯ In the intact dog, ACD CPR generates physiologically and statistically superior hemodynamics when compared with high-impulse manual CPR. Improved blood flow seems to be related to more efficient ventricular filling and emptying. These findings emphasize the biphasic nature of CPR and the importance of active decompression.
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Comparative Study Clinical Trial
A prospective comparison of paramedic judgment and the trauma triage rule in the prehospital setting.
To study paramedic judgment and the Trauma Triage Rule in prehospital trauma triage. ⋯ The TTR and paramedic judgment are effective in identifying patients who require trauma center care in the prehospital setting. The TTR and paramedic judgment combined have the greatest predictive value in identifying seriously injured patients.
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The establishment of pediatric emergency medicine as a subspecialty of emergency medicine has engendered the need for closer examination and development of guidelines for fellowship training. Core content and curriculum documents pertaining to fellowship training in pediatric emergency medicine for pediatric graduates have been published previously. ⋯ We believe that emergency physicians should take an active role in the creation and refinement of educational guidelines for fellowship training in pediatric emergency medicine for emergency medicine graduates. For this reason, we present a proposed core content outline in the hope that it will serve to foster this process.
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To document and analyze the quality and quantity of emergency physicians' sleep as a function of day and night shift work, and to compare cognitive and motor performance and mood during day and night shifts. ⋯ Attending emergency physicians get less sleep and are less effective when performing manual and cognitive tests while working night shifts with day sleep compared with working day shifts with night sleep.
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Comparative Study Clinical Trial
Facilitation of peripheral intravenous access: an evaluation of two methods to augment venous filling.
To evaluate two methods of augmenting venous filling as potential aids to i.v. cannulation. ⋯ Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused significant filling of antecubital fossa veins in excess of that produced by a venous tourniquet alone in normovolemic, normotensive volunteers.