The American journal of emergency medicine
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Review Meta Analysis
Delirium prevalence in geriatric emergency department patients: A systematic review and meta-analysis.
In the emergency department, delirium associated with serious adverse outcomes is common in geriatric patients. We performed a meta-analysis and estimated the prevalence of delirium and its related factors among geriatric emergency department patients. ⋯ In the emergency department, delirium is common in geriatric patients. We should pay specific attention to delirium screening, prevention, and treatment in geriatric patients. Overall appropriate interventions should be utilized to reduce the occurrence of delirium and the adverse outcomes.
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Multicenter Study Observational Study
Hypernatremia is associated with poor long-term neurological outcomes in out-of-hospital cardiac arrest survivors.
Brain oedema after cardiac arrest is strongly associated with poor neurological outcomes. Excessive sodium supplementation may increase serum osmolarity and facilitate brain oedema development in cardiac arrest survivors. We aimed to investigate the association of serum sodium levels with long-term neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. ⋯ Relatively high Sodium 24H levels showed a strong and independent association with poor long-term neurological outcomes in OHCA survivors. These findings may be applied in therapeutic strategies for improving neurological outcomes in OHCA survivors.
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Randomized Controlled Trial
Effects of vertical compression during pediatric cardiopulmonary resuscitation using the one-handed chest compression technique.
The posture of the rescuer while performing the one-handed chest compression (OHCC) has not yet been evaluated. This study aimed to investigate the effect of vertical compression during pediatric cardiopulmonary resuscitation (CPR) using the OHCC technique. ⋯ The vertical OHCC could provide a deeper and more adequate CCD compared with the conventional OHCC, and the advantages of the vertical OHCC originate from the superiority of the compression force.
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Randomized Controlled Trial
Randomized trial of three airway management techniques for restricted access in a simulated pediatric scenario.
Emergency pediatric airway management during restricted access to the head is challenging and may relate to an entrapped motor vehicle trauma. Video laryngoscopy and supraglottic airways have separately been described to facilitate face-to-face airway management. We hypothesized that video laryngoscopy might be superior to direct laryngoscopy or supraglottic device use to establish ventilation during face-to-face airway management, studied in a simulated pediatric entrapped motor vehicle scenario. ⋯ All three techniques have high success rates. Time to establish ventilation with the SGD was significantly faster compared to DL and VL and participants rated SGD easiest to use. The utility of VL was limited due to significantly longer time to ventilation, despite significantly improved view compared to DL, similar to adult studies. Since time and success are clinically important, this study suggests that supraglottic devices should be considered for primary emergency pediatric airway management in situations with restricted access to the head.
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Target hemoglobin (Hb) level is not clearly determined in patients followed up in the intensive care unit (ICU) for traumatic brain injury (TBI). This study aims to investigate the impact of red blood cell (RBC) transfusion and Hb level on the neurological outcome in the first 24 h in patients with TBI. ⋯ In patients followed up in the ICU due to TBI, RBC transfusion and Hb values in the first 24 h are not associated with PO at the time of discharge from the ICU.