Annals of emergency medicine
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To evaluate a standardized training program in intraosseous (IO) infusion for prehospital providers. ⋯ A one-hour standardized training session was successfully used to train prehospital providers in the procedure of IO infusion. IO infusion then was implemented into their clinical practice with a satisfactory success rate and few complications.
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Case Reports
Out-of-hospital quantitative monitoring of end-tidal carbon dioxide pressure during CPR.
To assess the feasibility and potential usefulness of quantitative measurement of end-tidal carbon dioxide pressure (PETCO2) during out-of-hospital cardiac arrest. ⋯ These preliminary pilot observations confirm the feasibility of quantitative capnography during out-of-hospital cardiac arrest and indicate that early institution of this noninvasive procedure may provide insight into pathophysiologic mechanisms such as pseudo-electromechanical dissociation and may also track changes in pulmonary blood flow during chest compressions or during spontaneous circulation.
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Case Reports
Pacemaker-twiddler's syndrome: a rare cause of lead displacement and pacemaker malfunction.
Pacemaker-twiddler's syndrome is characterized by spontaneous, subconscious, inadvertent, or deliberate rotation of the pulse generator by the patient resulting in lead dislodgement and pacemaker malfunction. We present a case of pacemaker-twiddler's syndrome that involved an atrioventricular sequential pacemaker. It resulted in failure of atrial lead capture and phrenic nerve stimulation but without loss of ventricular lead capture. A search of the literature revealed only ten previous cases reported; none were in the emergency medicine literature, and none involved an atrioventricular sequential pacemaker.
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To assess the frequency of institutional review board (IRB) review and informed consent in emergency medical services (EMS) research. ⋯ IRB review is often omitted by EMS investigators. This raises ethical concerns about EMS research. Investigators should document their consent method or approval to use an informed consent waiver in their manuscripts. A consent method should be specified for volunteers.