The American journal of emergency medicine
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Shared decision making (SDM) is a process whereby patients and clinicians work together to make informed medical decisions that incorporate patient values. Recent data suggest that, for patients with low pretest probability of pulmonary embolism (PE), doubling the standard d-dimer cutoff may reduce the need for imaging with minimal increase in missed PE diagnoses. We used an SDM approach to determine patient preferences regarding this diagnostic approach. ⋯ When presented with a hypothetical scenario, more than one-third of patients deferred imaging for PE based on low clinical probability and a d-dimer less than twice the normal threshold. An SDM approach is acceptable to patients and may decrease imaging for PE.
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The purposes of the study are to investigate the renal function in ventricular fibrillation (VF) and asphyxiation cardiac arrest in a swine model and to estimate the value of novel biomarkers in the acute kidney injury (AKI) after cardiac arrest. ⋯ Acute kidney injury at early stage of postresuscitation is common in different causes of cardiac arrest. Asphyxiation has more severe kidney injury and gets worse prognosis.
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The aim of this study is to evaluate the efficiency of a specific organizational model for early stroke management associated with repeated public awareness campaigns on stroke warning signs. ⋯ Educational programs repeated each year are useful to the population for learning how to recognize stroke symptoms and send straight away an emergency call. Combining the emergency action with an early remote evaluation by the stroke center team and a direct admission in imaging department shortens the time-to-treatment delay. This model is reproducible in different health care systems.
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Clinical Trial
Electromyography activity of selected trunk muscles during cardiopulmonary resuscitation.
Understanding trunk muscle activity during chest compression may improve cardiopulmonary resuscitation (CPR) training strategies of CPR or prevent low back pain. This study investigates the trunk muscle activity pattern of chest compression in health care providers to determine the pattern alternation during chest compression. ⋯ We suggest that the muscle power training for the pectoralis major, erector spinae, and rectus abdominis could be helpful for health care providers. Keeping muscle activity balance of bilateral gluteus maximus and maintaining the same level of EMG ratios might be the keys to prevent low back pain while performing CPR.
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Glyphosate-surfactant herbicide is promoted by the manufacturer as having no risks to human health. Glyphosate surfactant has recently been used with increasing frequency in suicide attempts, so clinical toxicologists occasionally encounter cases of severe systemic toxicity. The purpose of this study was to identify the early predictive factors of patients at risk for mortality and the usefulness of the corrected QT interval (QTc interval) for predicting mortality from glyphosate-surfactant intoxication. ⋯ Prolonged QTc interval seems to be a useful prognostic factor for mortality in patients intoxicated with glyphosate-surfactant herbicide.