The American journal of emergency medicine
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Ultrasonography (US) has gained popularity in the emergency medicine to assess intravascular volume status in critically ill patients. However, there are a limited number of studies on the interrater reliability of US examination of the inferior vena cava (IVC) by emergency residents. ⋯ The measurement of the IVC is moderately reliable by emergency residents. The interrater reliability of measurements in patients with profound and superficial located IVC is higher than that of measurements in patients with moderate-depth located IVC.
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Review Meta Analysis Comparative Study
Biphasic versus monophasic defibrillation in out-of-hospital cardiac arrest: a systematic review and meta-analysis.
Biphasic defibrillation is more effective than monophasic one in controlled in-hospital conditions. The present review evaluated the performance of both waveforms in the defibrillation of patients of out-of-hospital cardiac arrest (OHCA) with initial ventricular fibrillation (Vf) rhythm under the context of current recommendations for cardiopulmonary resuscitation. ⋯ Biphasic waveforms did not seem superior to monophasic ones with respect to Vf termination, ROSC, or survival to hospital discharge in OHCA patients with initial Vf rhythm under the context of current guidelines. However, most trials were conducted in accordance with previous guidelines for cardiopulmonary resuscitation. Therefore, further trials are needed to clarify this issue.
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Randomized Controlled Trial
Improvement in chest compression quality using a feedback device (CPRmeter): a simulation randomized crossover study.
Cardiac arrest survival depends on celerity and efficiency of life support action. Guidelines emphasized the chest compression (CC) quality and feedback devices are encouraged. The purpose is to study the impact of the CPRmeter feedback device on resuscitation performed by untrained rescuers. ⋯ The use of the CPRmeter significantly improved CC quality performed by students inexperienced in cardiopulmonary resuscitation.
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Many patients discharged from the emergency department (ED) require urgent follow-up with specialty providers. We hypothesized that a unique specialty referral mechanism that minimized barriers would increase follow-up compliance over reported and historical benchmarks. ⋯ A referral process that minimizes barriers can achieve an 80% follow-up compliance rate. Age, insurance, specialty type, and time to appointment are associated with noncompliance.
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Randomized Controlled Trial
One-hand chest compression and hands-off time in single-lay rescuer CPR-a manikin study.
To evaluate the effect of one-hand chest compression while continuously maintaining an open airway (OCOA) on rescue breath-associated hands-off time (RAHO) during single-lay rescuer cardiopulmonary resuscitation (CPR). ⋯ In our study, OCOA resulted in shorter RAHO and less stomach inflation. Our results indicate that the airway should be maintained open during chest compressions, regardless of the technique. Larger studies are needed for the full clarification of OCOA.