Annals of emergency medicine
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A number of studies have shown that expired CO2 concentration is closely related to cardiac output, but that cardiac output was not controlled as an independent variable. In addition, the partial pressure of end-tidal CO2 (PETCO2) during extremely low cardiac output has not been reported. The objective of the present study was to measure PETCO2 during well-controlled, very low blood flow rates under conditions of constant minute ventilation. ⋯ Under conditions of constant minute ventilation, PETCO2 correlated closely with cardiac index over a large range of blood flow rates, including extremely low rates.
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To determine the accuracy of end-tidal carbon dioxide levels as a measure of arterial carbon dioxide levels in nonintubated patients presenting to an emergency department for care. ⋯ Measurements of end-tidal carbon dioxide concentrations correlate well with PaCO2 values in nonintubated patients presenting with a variety of conditions to EDs. End-tidal carbon dioxide measurements may be sufficient measures of PaCO2 in selected patients and obviate the need for repeat arterial blood gas determination. Further study is warranted.
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To gather preliminary data on the safety and efficacy of IV magnesium in a rat model of hydrofluoric acid burns. ⋯ High-dose IV magnesium sulfate reduces the severity of hydrofluoric acid burn compared with conventional intradermal calcium gluconate therapy. Early deaths appeared to be prevented by both calcium and magnesium therapies.
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To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the ED length of stay and procedures performed in medical critical care patients. ⋯ Critically ill patients spend a substantial amount of time in the ED before transfer to the ICU. Typical ICU procedures are commonly performed. Further study of the impact on patient outcome of ED stay and the procedures performed in critically ill medical patients should be conducted.
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We investigated the hydrodynamic characteristics of IV infusion sets for rapid fluid resuscitation. A simple technique has been devised for quantitative evaluation of the hydrodynamic characteristics of IV sets, including their components, for a range of infusion pressures. ⋯ At gravity-delivered pressures (50 and 100 mm Hg), the only effective way of increasing flow rate (more than twofold) is to use a low-resistance drip chamber or to use two infusion sites. At pressurized delivery pressures (more than 200 mm Hg), increasing catheter size from 18 to 14 gauge would be more effective than doubling the number of infusion sets. Also, a more efficient drip chamber adds an important advantage. Finally, increasing the tubing diameter adds only minimal benefit.