Annals of emergency medicine
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To compare cardiopulmonary bypass (CPB) with more conventional therapy in the treatment of severe amitriptyline poisoning. ⋯ CPB improved survival in our swine model of severe amitriptyline poisoning.
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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.
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Randomized Controlled Trial Clinical Trial
Reducing the pain of local anesthetic infiltration: warming and buffering have a synergistic effect.
To compare room-temperature unbuffered lidocaine, warm lidocaine, buffered lidocaine, and warm buffered lidocaine to determine which of the four solutions is least painful during infiltration. ⋯ Skin infiltration with warm buffered lidocaine is significantly less painful than infiltration with room-temperature unbuffered lidocaine, warm lidocaine, or buffered lidocaine.
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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.