Annals of emergency medicine
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Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for selected patients when conventional cardiopulmonary resuscitation (CPR) fails. Current evidence suggests that the success of eCPR depends on well-structured in- and out-of-hospital protocols. This article describes the Vienna eCPR program, and the interventions implemented to improve clinical processes and patient outcomes. ⋯ After restructuring the Vienna eCPR program, we were able to improve survival rates with favorable neurologic outcomes after eCPR. This improvement was accompanied with increased case volumes, rates of witnessed arrest, bystander CPR, and initial shockable rhythm, and decreased low-flow durations. The learning curve we observed illustrates that outcomes can improve with experience, a summation effect of training, patient selection, and process standardization.
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We use national emergency department (ED) data to identify the proportion of "telehealth-able" ED visits, defined as potentially conductible by Video Only or Video Plus (with limited outpatient testing). ⋯ Between 3% and 10% of United States ED visits may be potentially telehealth-able for patients aged 4 years and older, considering the first listed RFV and ED visit characteristics. Fewer visits may be telehealth-able when all reasons for visits are considered.
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This study analyzes emergency medicine airway management trends and outcomes among community emergency departments. ⋯ Physicians intubating in community emergency departments have similar rates of first-pass success and failure seen in academic Level-1 trauma centers despite treating medically sick patients with high all-cause mortality rates. Dramatic shifts in choice of paralytic and method for intubation were seen.
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The peripheral intravenous catheter (IV) is the most common and painful invasive medical device in acute care settings. Our objective was to determine whether adding skin glue to secure IVs reduced catheter failure rate in children. ⋯ This study found no benefit in using skin glue to secure IVs in the ED in children.