Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of 2 cricothyrotomy techniques: standard method versus rapid 4-step technique.
To compare the success rate, complication rate and time required for the rapid 4-step technique versus the standard technique for cricothyrotomy. ⋯ In a group of inexperienced subjects working on a preserved human cadaver model, the rapid 4-step technique for cricothyrotomy was performed in about one third the time required for performance of the standard technique. This finding was both clinically and statistically significant. Although the 2 techniques had similar success and complication rates, we noted a trend toward more severe complications in the rapid 4-step technique.
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Studies indicate that ventricular tachycardia (VT) and ventricular fibrillation (VF) are no longer the most common rhythms initially documented in out-of-hospital sudden cardiac death. Although the outcome from asystole and rhythms designated as pulseless electrical activity (PEA) is reported as poor (approximately 1% survival), resuscitative efforts for these patients are still encouraged. The purpose of this study was to determine the potential contribution that this patient group makes to overall survivorship. ⋯ In this study, patients in asystole/PEA comprised 90% of the survivors. The outcome for patients with asystole/PEA whose arrest was witnessed and who received bystander CPR may be greater than previously estimated and supports the current practice of initiating aggressive out-of-hospital ACLS in this patient group.
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A widely diverse body of information exists on the use of Advanced Life Support procedures by prehospital personnel. We compared and contrasted the literature that currently exists on this topic. We examined methodologies, results, and conclusions for each article. We also stress the need for critical clinical evaluations in this arena.
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To determine the clinical characteristics of endotracheal intubation in the French emergency prehospital medical system and compare these data with those of other systems. ⋯ The characteristics of French prehospital airway management differ significantly from those of other countries. These differences may be explained by differences in approach to prehospital management rather than differences of skill.
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We present 2 cases in which the transfusion of small volumes of packed RBC was sufficient to precipitate symptomatic hypocalcemia. Subsequent inquiry revealed that both of the patients had preexisting, untreated, and asymptomatic hypocalcemia, 1 following partial thyroidectomy many years earlier and the other with documented hypocalcemia but without a definitive diagnosis.