Annals of emergency medicine
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To quantify the effects of graded upper-airway obstruction on the delivered tidal volume and selected parameters of pulmonary mechanics during transtracheal jet ventilation (TTJV) in a dog model. ⋯ Partial upper-airway obstruction increases the delivered tidal volume, minute ventilation, and transpulmonary pressure of the lungs during TTJV, with consequent decreases in the arterial PCO2 as the amount of obstruction increases. No significant changes were seen in the quasistatic compliance of the lungs, pulmonary flow resistance, or alveolar:arterial gradient, lending support to the position that TTJV is a safe technique under conditions of partial upper-airway obstruction. However, due to significant increases in tidal volume and functional residual capacity and decreases in mean arterial blood pressure, concerns still exist during near-total or total upper-airway obstruction.
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Comparative Study
Efficacy of nurses suturing pediatric dermal lacerations in an emergency department.
To assess the efficacy of nurses suturing pediatric dermal lacerations in an emergency department. ⋯ Nurses who complete a standardized training program in wound management and repair are capable of providing high-quality, definitive care for children with dermal lacerations, thus allowing physicians to use their time more effectively in managing general patient care in the ED.
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To determine the rate and cause of death of patients who were evaluated in the emergency department and discharged and how the cause of death related to the ED visit. ⋯ Death after discharge from the ED is uncommon. The most common cause of unexpected, directly related death is ruptured aortic aneurysm.
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To determine which adult patients with new-onset seizures require admission and whether those who require admission can be identified in the emergency department. ⋯ One half of patients with new-onset seizures require admission. Patients with new-onset seizures who require admission can usually be detected by a standardized medical evaluation in the ED.