The American journal of emergency medicine
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Multicenter Study
Mortality risk factors in patients receiving ECPR after cardiac arrest: Development and validation of a clinical prognostic prediction model.
Previous studies have shown an increasing trend of extracorporeal cardiopulmonary resuscitation (ECPR) use in patients with cardiac arrest (CA). Although ECPR have been found to reduce mortality in patients with CA compared with conventional cardiopulmonary resuscitation (CCPR), the mortality remains high. This study was designed to identify the potential mortality risk factors for ECPR patients for further optimization of patient management and treatment selection. ⋯ Risk factors have been identified among ECPR patients including a history of cerebrovascular diseases, higher Lac and presence of PEA or asystole. While factor such as age 45-60, higher pH and use of IABP have been found protective against in-hospital mortality. These factors can be used for risk prediction, thereby improving the management and treatment selection of patients for this resource-intensive therapy.
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Spontaneous cervical artery dissection (sCAD) is a serious condition that carries with it a high rate of morbidity and mortality. ⋯ An understanding of sCAD can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
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Acute diverticulitis is a condition commonly seen in the emergency department (ED). Therefore, it is important for emergency medicine clinicians to be aware of the current evidence regarding the diagnosis and management of this disease. ⋯ An understanding of literature updates can improve the ED care of patients with acute diverticulitis.
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Randomized Controlled Trial
Chest compression quality comparing 1-min vs 2-min rotation of rescuers wearing N95 masks.
During the COVID-19 pandemic, cardiopulmonary resuscitation (CPR) performed by rescuers wearing well-sealed respirators such as N95 masks, was associated with significant reduction in the chest compression rate and depth. This was attributed to fatigue during the standard 2-min rescuer rotations. We hypothesized that in such situations, rotating rescuers every one minute, instead of the standard two minutes would improve CPR quality. ⋯ During CPR performed by rescuers wearing N95 masks, the quality of CPR appears to be superior with rescuers rotating at 1-min instead of 2-min intervals. More frequent rotation was also associated with less rescuer fatigue.