The American journal of emergency medicine
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The purposes of this study were to measure the chest wall thicknesses (CWTs) at second intercostal space (ICS) mid-clavicular line (MCL) and fifth ICS MAL directly, and compare the actual success rates of needle thoracostomies (NTs) by inserting a 5-cm-long syringe needle. Predictive values of weight, body mass index (BMI) and CWT were also analyzed. ⋯ In this report, we present the largest cadaver-based cohort to date to the best of our knowledge, and we observed a statistically nonsignificant 9% more NT success rate at 2nd ICS at a power of 88% and statistically significant more success rate in males at 5th ICS was (47.7%). We also observed thinner CWTs and higher success rates than previous imaging-based studies. A BMI of 23 kg/m2 or less and weight of 72 kg or less seem to accurately rule-out NT failure in cadavers, and they seem to be better predictors at the bedside.
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In this study, we aimed to identify oxidative stress and the disruption in the oxidant-antioxidant balance in the acute phase of stroke and, therefore, to detect markers that will guide in the diagnosis and treatment of stroke. ⋯ It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore, these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.
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Studies suggest that collaborative nursing protocols initiated in triage improve emergency department (ED) throughput and decrease time to treatment. ⋯ Emergency department triage pain protocol decreased time to provision of pain medications and did so without respect to payer category, sex, or race.
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Observational Study
The impact of push-dose phenylephrine use on subsequent preload expansion in the ED setting.
The utilization of bolus-dose phenylephrine (PHE) has transitioned to the emergency department (ED) for the treatment of acutely hypotensive patients, despite a paucity of literature in this setting. ⋯ Initial preload IVF expansion was found to be significantly disproportionate, and appears to be associated with an increase number of phenylephrine bolus doses in our study population.
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This study determined if rescuer body weight is a major determinant of chest compression depth (CCD) among novice rescuers by analyzing the results of cardiopulmonary resuscitation (CPR) skill tests among medical students and determined the body weight threshold for those unable to achieve adequate CCD. ⋯ Rescuer body weight is a major determinant of CCD in novice rescuers. Based on these findings, if 2 or more rescuers are available to perform CPR, chest compression should preferentially be performed by rescuers of healthy weight or overweight.