Annals of emergency medicine
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To describe the development of an injury-surveillance system based on the emergency department log. ⋯ With minimal training and cost, the ED log can be adapted for collection of injury data on all patients seen in the ED.
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To determine whether family members of recently deceased emergency department patients would consent to the performance of a cricothyrotomy on the deceased for educational purposes. ⋯ Although there are difficulties in obtaining consent to perform invasive procedures on the recently deceased in the ED for educational purposes, our study demonstrates that many families will consent to such procedures if adequate information and explanation are provided. The results of this study may not be applicable to institutions serving patients with different cultural and ethnic backgrounds.
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For patient and personnel safety, agitated and violent individuals are sometime physically restrained during out-of-hospital ambulance transport. We report two cases of unexpected death in restrained, agitated individuals while they were being trans-ported by advanced life support ambulance. ⋯ In both cases the cause of death was determined to be positional asphyxiation during restraint for excited delirium. Physicians and emergency service personnel should be aware of the potential complications of using physical restraints for control of agitated patients.
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Meta Analysis
Effect of out-of-hospital defibrillation by basic life support providers on cardiac arrest mortality: a metaanalysis.
Although some studies demonstrate otherwise, we hypothesized that metaanalysis would demonstrate a reduction in the relative risk of mortality when basic life support (BLS) providers can defibrillate out-of-hospital cardiac arrest patients. ⋯ BLS defibrillation can reduce the relative risk of death for out-of-hospital cardiac arrest victims in ventricular fibrillation. Weaknesses in individual study designs and regional clustering limit the strength of this metaanalysis and conclusion.