The American journal of emergency medicine
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Randomized Controlled Trial
Transcutaneous electrical nerve stimulation (TENS) for the treatment of renal colic in the emergency department: A randomized, double-blind, placebo-controlled trial.
To determine the analgesic efficacy of TENS treatment in patients with renal colic in the emergency department (ED). ⋯ TENS is effective for acute pain treatment in renal colic patients in the ED. TENS therapy could be a treatment option for renal colic.
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This narrative review explores current literature base detailing the effectiveness of alternative CPR instruction as compared to traditional CPR courses in the lay population. Assessment of alternative instructional methods found that video self-instruction and simplified CPR formats resulted in equivalent performance of CPR metrics and practical scenario assessment performance, as compared to traditional CPR instruction courses. While additional research is needed to further substantiate the value of self-directed learning, interactive digital, and abbreviated formats, these studies also suggested equivalence in CPR performance compared to traditional courses. In view of the importance of bystander CPR in OHCA outcomes, and the barriers presented by traditional CPR education courses, we recommend that public safety leaders and CPR educators strongly consider the introduction of these programs within their communities and classrooms.
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Multicenter Study Observational Study
Early identified risk factors and their predictive performance of brain death in out-of-hospital cardiac arrest survivors.
Early prediction of brain death (BD) after the return of spontaneous circulation (ROSC) in patients with cardiac arrest would be useful for the proper distribution of good quality transplantable organs and medical resources. We aimed to early identify independent risk factors of BD and their predictive performance in out-of-hospital cardiac arrest (OHCA) survivors. ⋯ High levels of initial serum NSE and PLR obtained within 6 h after ROSC may help early predict progression to BD in OHCA survivors. A large prospective multicenter study should be conducted to confirm these results.
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Review
Transcatheter aortic valve replacement complications: A narrative review for emergency clinicians.
Aortic valve stenosis (AS) is present in up to 10% of individuals over age 80 years. Transcatheter aortic valve replacement (TAVR) has become the most common method to replace the aortic valve in patients with AS. TAVR-related complications may occur. ⋯ Emergency clinicians are more likely to encounter TAVR complications after the initial procedural hospitalization and must be prepared to diagnose and manage these complications.
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There exists a need for prognostic tools for the early identification of COVID-19 patients requiring intensive care unit (ICU) admission and mortality. Here we investigated the association between a clinical (initial prehospital shock index (SI)) and biological (initial prehospital lactatemia) tool and the ICU admission and 30-day mortality among COVID-19 patients cared for in the prehospital setting. ⋯ Neither prehospital initial SI nor lactatemia were associated with ICU admission and 30-day mortality among COVID-19 patients initially cared for by a Paris Fire Brigade BLS or ALS team. Further prospective studies are needed to confirm these preliminary results.