Annals of emergency medicine
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of cardiopulmonary resuscitation training methods for parents of infants at high risk for cardiopulmonary arrest.
To compare three different methods of teaching CPR to parents of infants at high risk for sudden cardiopulmonary arrest and to identify characteristics that predict difficulty in learning CPR. ⋯ Most parents of infants at high risk for sudden death can demonstrate successful CPR skills at the completion of 1 class. However, a significant minority will require extra attention to be successful. Self-training video instruction may not be an adequate substitute for instructor-taught CPR.
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Review Case Reports
Reversal of midazolam-induced laryngospasm with flumazenil.
Midazolam is a commonly used benzodiazepine that is ideal for conscious sedation during a variety of procedures. Laryngospasm is listed by the manufacturer as a rare side effect of midazolam. Flumazenil is a competitive inhibitor of the benzodiazepines that is available for reversal at the end of such a procedure or when too much sedation has been achieved. ⋯ The symptoms recurred after approximately 25 minutes and were again reversed with flumazenil. Neither midazolam-induced laryngospasm nor its reversal with flumazenil have previously been reported. A brief discussion regarding laryngospasm and the use of flumazenil are included.
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We report a case of factitious disorder by proxy (FDBP), formerly known as Munchausen syndrome by proxy, in which 2 siblings were poisoned with diphenhydramine. Although diphenhydramine is a readily available medication, no report of its use as the sole agent in an FDBP case was found in a literature search. Although sibling involvement in FDBP is well documented, this is the first case report of 2 siblings hospitalized simultaneously because of intentional poisoning with the same substance. Finally, the use of physostigmine to definitively diagnose anticholinergic poisoning in a case of FDBP has not previously been described.
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The development and validation of a pediatric emergency department severity of illness assessment method, using hospital admission as the primary outcome. ⋯ The probability of admission to the hospital can reliably be estimated from data available during the pediatric ED stay. Applications for this method include studies of quality and efficiency of care and measurements of severity of illness.
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To assess whether transthoracic impedance and peak current are determinants of defibrillation success in patients with out-of-hospital ventricular fibrillation (VF). ⋯ OHCA shock success and survival are associated with EMS system factors such as the interval from when the call was received until delivery of the first shock. The importance of impedance and peak current remain theoretic for out-of-hospital defibrillation success and did not influence defibrillation success in this study.