The American journal of emergency medicine
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Randomized Controlled Trial
Effect of synchronous online vs. face-to-face cardiopulmonary resuscitation training on chest compression quality: A pilot randomized manikin study.
The aim of the study was to compare the effect of synchronous online and face-to-face cardiopulmonary resuscitation (CPR) training on chest compressions quality in a manikin model. ⋯ Synchronous online training with an AVF device would be a potential alternative approach to face-to-face chest compression training. Synchronous online training with AVF devices seems to be a suitable replacement for face-to-face training to offer adequate bystander CPR chest compression training.
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Observational Study
The physical examination is unreliable in determining the location of the distal fibular physis.
Salter-Harris type 1 (SH1) fractures of the distal fibula are acute orthopedic injuries with tenderness over the physis without radiographic evidence of fracture. Our primary objective was to establish the accuracy of the physical examination performed by pediatric emergency medicine (PEM) physicians in determining the location of the distal fibular physis compared to a criterion standard of ultrasound. ⋯ PEM physicians were unable to accurately identify the distal fibular physis on physical examination.
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Several case reports suggest that penetrating thoracic cage fractures are an important cause for hemopericardium and cardiac tamponade following blunt trauma. However, the prevalence of this mechanism of injury is not fully known, and considering this association may provide a better understanding of the utility of cardiac component of the FAST (Focused Assessment with Sonography for Trauma). ⋯ Thoracic cage fractures secondary to blunt trauma represent a significant independent risk factor for the development of a pericardial effusion. Our findings lend support for the mechanism of bony injuries causing penetrating cardiac trauma. Given these findings, and the fact that many thoracic cage fractures are detected after the initial evaluation, we support maintaining the cardiac view in the FAST examination for all blunt trauma patients.
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Multicenter Study
Assessment of glufosinate-containing herbicide exposure: A multi-center retrospective study.
Exposure to glufosinate ammonium, an herbicide used worldwide, can cause CNS and respiratory toxicities. This study aimed to analyze acute human glufosinate ammonium poisoning. ⋯ Old age, change in consciousness, and paraquat co-exposure were associated with higher mortality in human glufosinate poisoning. Age > 70 years and GCS score < 9 at triage could be predictors of mortality in patients with acute oral glufosinate poisoning.
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Multicenter Study Observational Study
Decision tree analysis to predict the risk of intracranial haemorrhage after mild traumatic brain injury in patients taking DOACs.
Although the preliminary evidence seems to confirm a lower incidence of post-traumatic bleeding in patients treated with direct oral anticoagulants (DOACs) compared to those on vitamin K antagonists (VKAs), the recommended management of mild traumatic brain injury (MTBI) in patients on DOACs is the same as those on the older VKAs, risking excessive use of CT in the emergency department (ED). ⋯ The machine-based CHAID model identified distinct prognostic groups of patients with distinct outcomes based on clinical factors. Decision trees can be useful as guides for patient selection and risk stratification.