Annals of emergency medicine
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To assess emergency physician knowledge of and effect on clinical practice of the ACEP "Clinical Policy for Management of Adult Patients Presenting With a Chief Complaint of Chest Pain, With No History of Trauma." ⋯ Fewer than half the emergency physicians we surveyed were aware of the policy. Of the physicians who said they had been aware of the policy, most did not know important specifics of the policy.
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We sought to determine whether the interval between the arrival of first responder/defibrillators and paramedic advanced life support (ALS) interventions is associated with outcome. ⋯ Faster response by medics, or any individual ALS intervention other than first-responder defibrillation, demonstrated no benefit in this urban population with short intervals between responder arrivals. Aggressive ALS increased the number of survivors but also decreased their neurologic quality. The benefit of rapid ALS backup to first responder/defibrillators needs further study in other systems. System performance cannot be judged without knowledge of neurologic outcome.
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To determine whether the computer-derived measures of median frequency or peak amplitude of ventricular fibrillation (VF), obtained by fast Fourier transform of the VF waveform, change during selective aortic arch perfusion in a canine model of cardiac arrest. ⋯ Median frequency and peak amplitude increase with SAAP during cardiac arrest in a canine model. This method of resuscitation was reliable in allowing restoration of a stable perfusing rhythm after defibrillation. Changes in measures of peak amplitude and median frequency may reflect interventions that enhance the likelihood of successful defibrillation and may thereby offer a noninvasive means of monitoring interventions during cardiac arrest.