Annals of emergency medicine
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To assess patients' comprehension of their emergency department discharge instructions and to determine if inner-city patients' literacy levels are adequate to comprehend written discharge instructions. ⋯ Overall comprehension rates in this population were good despite the fact that ED instruction sheets were written at an inappropriately high reading level. Verbal instructions given by the discharging physician likely have a significant effect on patients' comprehension of instructions.
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To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians. ⋯ Despite biannual ACLS training of all medical residents and ICU nurses, noncompliance with ACLS guidelines was noted in 35.2% of treatments. We found no correlation between ACLS certification and ACLS guideline compliance.
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Randomized Controlled Trial Comparative Study Clinical Trial
End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: comparison of active compression-decompression and standard CPR.
To compare the maximal end-tidal carbon dioxide pressure (ETCO2 peak) values obtained during standard (S-CPR) and active compression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest. ⋯ This prospective study suggests that ACD-CPR may improve cardiac output compared with S-CPR.
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Comparative Study
Comparison of prehospital monomorphic and polymorphic ventricular tachycardia: prevalence, response to therapy, and outcome.
Monomorphic ventricular tachycardia (MVT) is the most common form of prehospital ventricular tachycardia (VT). Recent literature suggests that polymorphic ventricular tachycardia (PVT) is more common during cardiopulmonary arrest than previously thought but responds poorly to advanced cardiac life support (ACLS) therapy. We undertook this study to determine the prevalence, response to therapy, and outcome of both MVT and PVT in the prehospital sudden cardiac death victim. ⋯ We conclude that PVT is a common rhythm occurring in prehospital cardiopulmonary arrest that responds as well as MVT to ACLS therapy. Until prospective data are available, standard ACLS therapy should be used in all forms of prehospital VT occurring during cardiopulmonary arrest.
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To determine whether routine pulse oximetry in a pediatric emergency department can be used to identify patients with a low oxygen saturation (SaO2) that is unexpected on the basis of clinical evaluation. ⋯ Clinical evaluation in a pediatric ED does not screen adequately for the detection of hypoxemia and should be supplemented by routine pulse oximetry in all patients with respiratory findings.