The American journal of emergency medicine
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Multicenter Study
Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters.
Obtaining intravenous (IV) access in the emergency department (ED) can be especially challenging, and physicians often resort to placement of central venous catheters (CVCs). Use of ultrasound-guided peripheral IV catheters (USGPIVs) can prevent many "unnecessary" CVCs, but the true impact of USGPIVs has never been quantified. This study set out to determine the reduction in CVCs by USGPIV placement. ⋯ Ultrasound prevented the need for CVC placement in 85% of patients with difficult IV access. This suggests that USGPIVs have the potential to reduce morbidity in this patient population.
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Multicenter Study
Duration of well-controlled core temperature correlates with neurological outcome in patients with post-cardiac arrest syndrome.
Detailed procedures for optimal therapeutic hypothermia (TH) have yet to be established. We examined how duration of well-controlled core temperature within the first 24 hours after cardiac arrests (CA) correlated with neurological outcomes of successfully resuscitated out-of-hospital CA (OHCA) patients. ⋯ TH maintained at target temperature of 33 °C ± 1 °C over 18 hours independently correlated with favorable neurological outcome. Therefore, stable core temperature control may improve neurological outcome of successfully resuscitated OHCA.
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Randomized Controlled Trial
An electrocardiogram technician improves in-hospital first medical contact-to-electrocardiogram times: a cluster randomized controlled interventional trial.
In the case of chest pain, the current guidelines require electrocardiogram (ECG) recording and patient assessment within 10 minutes upon arrival in the emergency department. ⋯ Delays of iFMC-to-ECG can be effectively addressed by implementation of an ECG-T. The service of an ECG-T is feasible and improves staff satisfaction. Both ECG-to-EP time and ECG assessment constitute no relevant delay.
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Randomized Controlled Trial
External laryngeal manipulation does not improve the intubation success rate by novice intubators in a manikin study.
External laryngeal manipulation (ELM) is a technique used in cases of poor glottic view in direct laryngoscopy. Studies investigating ELM in the pediatric population are lacking. The objective of this study was to examine if use of ELM by inexperienced intubators improves the success rate of pediatric intubation. ⋯ In this pediatric manikin study, ELM performed by novice intubators improved laryngeal view, but lengthened the duration of intubation and did not improve intubation success rate.
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The objective of this study is to evaluate the diagnostic performance of the BinaxNow Influenza A&B rapid antigen test (RAT) in emergency department (ED) patients. ⋯ The BinaxNow RAT demonstrated high specificity and poor sensitivity in ED patients selected by treating clinicians for influenza testing. A negative RAT is a poor predictor for the absence of influenza in the ED and should not be used as a criterion to withhold antiviral medications.