Annals of emergency medicine
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All original articles published in JACEP and Annals of Emergency Medicine in 1972, 1975, 1978, and 1981 were reviewed and classified according to type of article, research design, specific methods utilized, and statistical analyses employed. The number of articles published annually increased during the 10-year period, from 34 in 1972 to 131 in 1981. The percentage of articles devoted to clinical research, basic science, animal studies, and health services research also increased: 1972, 8.8%; 1975, 39.6%; 1978, 41.2%; and 1981, 51.1%. ⋯ In 1972, statistical analysis was limited to descriptive enumeration and was included in only three articles. In 1981, 62 articles contained statistical analyses, including chi square in 11; t test in 6; Fischer's exact test in 2; ANOVA in 4; and P value (method not stated) in 10. This study reveals a major increase in both the quality and quantity of emergency medicine research published during the 10-year period reviewed.
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Three hundred twenty emergency medical technicians (EMTs) were tested for their ability to ventilate a precalibrated Recording Resusci-Annie (Laerdal Medical Corporation) using both a bag-valve-mask and a pocket mask. More than 50% of the EMTs were not capable of ventilating to the minimum standard using a bag-valve-mask. The study demonstrates that the pocket mask method is far superior to the bag-valve-mask method. If these experimental results are confirmed by clinical findings, we recommend that future educational courses teach the bag-valve-mask as a four-hand/two-person skill, with one rescuer squeezing the bag with both hands and the second rescuer maintaining hyperextension.
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Length of resuscitation in prehospital ventricular fibrillation patients was studied to define its relationship to survival. Five hundred sixty-five patients presenting with the initial rhythm of ventricular fibrillation to the Milwaukee County Paramedic System between January 1978 and April 1982 were resuscitated successfully. Pediatric patients and patients with trauma, poisoning, and drowning were excluded. ⋯ The overall survival curve of witnessed arrest patients was not statistically different from that of unwitnessed patients. The survival curve of those patients receiving bystander cardiopulmonary resuscitation (CPR) was similar to the curve of those who received no CPR. We conclude that resuscitation time is a heretofore undefined significant predictor of survival of resuscitated prehospital ventricular fibrillation patients.
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Nitrous oxide levels of 300 to 500 ppm occur when nitrous oxide is administered in the emergency department using the Nitronox machine without use of the scavenger device, which traps expired nitrous oxide gases and vents them to the outside environment. A scavenger device that can limit nitrous oxide gas to zero ppm in the emergency department setting has been developed. We think that development of the scavenger device is a significant advance for the safe administration of nitrous oxide in the emergency department.