The American journal of emergency medicine
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The objective of this study was to evaluate the effectiveness of a streamlined interfacility referral protocol in reducing door-to-balloon (D2B) times for patients experiencing acute ST-segment elevation myocardial infarction (STEMI). ⋯ The implementation of a streamlined referral protocol has significantly reduced D2B times for patients diagnosed with STEMI that required interfacility transport for intervention.
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Randomized Controlled Trial Comparative Study
A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation.
The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. ⋯ The longitudinal method of visualizing the axillary vein during ultrasound-guided venous access is associated with greater first-attempt success, fewer needle redirections, and a trend of fewer arterial punctures compared with the transverse orientation.
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Randomized Controlled Trial
Impact of stylet use in a simulated difficult airway model.
Stylet use during endotracheal intubation (ETI) is variable across medical specialty and geographic location; however, few objective data exist regarding the impact of stylet use on ETI performance. ⋯ Stylet use does not improve attempt time in a simulated difficult airway model for either inexperienced or experienced intubators.
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Clinical Trial
Use and efficacy of nebulized naloxone in patients with suspected opioid intoxication.
To describe the use and efficacy of nebulized naloxone in patients with suspected opioid intoxication. ⋯ Nebulized naloxone was well-tolerated and led to a reduction in the need for supplemental oxygen as well as improved median GCS and RASS scores in patients with suspected opioid intoxication.
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Clinical Trial
Systematic combined noncontrast CT-CT angiography in the management of unexplained nontraumatic coma.
Nontraumatic impaired consciousness is a common issue in emergency departments with a serious but widely variable prognosis. ⋯ Systematic combined NCCT/CTA imaging is an efficient tool for predicting poor neurologic prognosis in cases of unexplained nontraumatic impaired consciousness and is also essential for detecting BAO.