Annals of emergency medicine
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To describe an effective methodology for the investigation of prehospital cardiac arrest in large cities. ⋯ Concurrent, interactive acquisition of prehospital cardiac arrest data in a large urban setting captured over 98% of the core data recommended for completion of the Utstein template. This methodology may be a suitable means of investigating prehospital cardiac arrest in large cities.
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Pulse oximetry has been reported to be falsely elevated in the presence of carbon monoxide (CO). However, the degree to which pulse oximetry overestimates measured oxyhemoglobin saturation (O2Hb) has not been investigated in patients with CO exposure. This study quantifies the effect of CO on pulse oximetry and O2Hb in a series of patients with elevated carboxyhemoglobin (COHb) levels. ⋯ Oxygen saturation as measured by pulse oximetry failed to decrease to less than 96% despite COHb levels as high as 44%. Regression between the pulse oximetry gap and COHb suggests that pulse oximetry overestimates O2Hb by the amount of COHb present. Pulse oximetry is unreliable in estimating O2Hb saturation in CO-exposed patients and should be interpreted with caution when used to estimate oxygen saturation in smokers.
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To analyze open-wheel racing accidents at Indianapolis Raceway Park during six seasons (1988 through 1993) and describe factors that improve driver safety. ⋯ Although open-wheel racing is one of the most common forms of motorcar racing, there have been no previously published studies regarding injury patterns or medical care at these events. This study reviewed race driver injuries during six seasons of open-wheel racing at the Indianapolis Raceway Park. During 61 open-wheel racing events, no drivers were killed, but two required intensive care hospitalization.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of placement of the laryngeal mask airway with endotracheal tube by paramedics and respiratory therapists.
To determine the learning curve of nonphysician emergency personnel on placement of the laryngeal mask airway as compared to performance of endotracheal intubation. ⋯ The techniques were timed from the point at which the participant touched the patient to the time they were able to effectively ventilate the patient. Participants also were asked to rate the difficulty of each technique on a 100-mm visual analog score. Failure (three attempts without successful ventilation) rates also were monitored. The mean time to ventilate successfully with the laryngeal mask airway was significantly less than that with the endotracheal tube (38.9 +/- 1.9 seconds versus 206.1 +/- 31.9 seconds, P < .0001). The average number of attempts was 1.0 +/- 0.0 for the laryngeal mask airway and 2.22 +/- 0.21 for the endotracheal tube (P < .01). No one failed to place the laryngeal mask airway; and ten of 19 (52.6%, P < .01) failed to perform endotracheal intubation. The endotracheal tube had a significantly higher rating of difficulty than did the laryngeal mask airway (67.3 versus 8.64, P < .0001).