Annals of emergency medicine
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Individuals in neighborhoods composed of minority and lower socioeconomic status populations are more likely to have an out-of-hospital cardiac arrest event, less likely to have bystander cardiopulmonary resuscitation (CPR) performed, and less likely to survive. Latino cardiac arrest victims are 30% less likely than whites to have bystander CPR performed. The goal of this study is to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO. ⋯ Distrust of law enforcement, language concerns, lack of recognition of cardiac arrest, and financial issues must be addressed when community-based CPR educational programs for Latinos are implemented.
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We determine the cost-effectiveness of out-of-hospital continuous positive airway pressure (CPAP) compared with standard care for adults presenting to emergency medical services with acute respiratory failure. ⋯ The cost-effectiveness of out-of-hospital CPAP is uncertain. The incidence of patients eligible for out-of-hospital CPAP appears to be the key determinant of cost-effectiveness.
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Editorial Comment
Do Mechanical Devices Improve Return of Spontaneous Circulation Over Manual Chest Compressions in Out-of-Hospital Cardiac Arrest?
Data are inadequate to determine whether recent devices (either load-distributing band or piston-driven) confer benefit or harm, though early trial data suggest they do not.
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Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Journal of the American Medical Association publication on the Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism (ADJUST-PE) trial by Righini et al. The objective is to describe a 14-day (August 25 to September 7, 2014) worldwide academic dialogue among clinicians in regard to 4 preselected questions about the age-adjusted D-dimer cutoff to detect pulmonary embolism. ⋯ Common themes that arose in the multimodal discussions included the heterogeneity of practices, D-dimer assays, provider knowledge about these assays, and prevalence rates in different areas of the world. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide audience in scholarly discourse.