The American journal of emergency medicine
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The objective of this study was to report the authors' experience using intravenous ketorolac (Syntex Laboratories, Palo Alto, CA) as an analgesic in the treatment of renal colic in a convenience sample at three suburban community hospital emergency departments. Twenty-five patients with renal colic were participants. Pregnant women, patients with a history of renal or hepatic impairment, bleeding diathesis, active peptic ulcer disease, or hypersensitivity to aspirin or nonsteroidal antiinflammatory drugs (NSAID) were excluded. ⋯ Thereafter, the median pain scores and (interquartile ranges) were 8 (three) at 5 minutes, 5 (four) at 10 minutes, 2 (four) at 20 minutes, 1 (three) at 30 minutes, and 0 (one) at 60 minutes. There were no adverse side effects observed in any patients. Therefore, it can be concluded that intravenous ketorolac is an effective analgesic agent for the control of pain in patients with renal colic.
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Comparative Study
Cricothyrotomy performed by prehospital personnel: a comparison of two techniques in a human cadaver model.
Little is known about the proficiency of prehospital personnel when performing cricothyrotomies. The authors compared two techniques for establishing an airway through the cricothyroid membrane used by paramedic students. One technique used a prepackaged kit that consisted of a dilator that is passed percutaneously through a breakaway needle. ⋯ Similar, statistically significant differences for insertion time and ease of insertion were again found. Prehospital personnel can be trained to perform cricothyrotomies with a reasonable degree of proficiency. A traditional surgical approach, however, may be faster and less difficult to perform than a comparable procedure using a commercially available percutaneous device.
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The purpose of this investigation was to determine factors associated with survival from out-of-hospital cardiac arrest, including effects of 911 Emergency Medical Services telephone access and the age of patient. Subjects included 1,753 prehospital cardiac arrest patients in Iowa. ⋯ This association was partially the result of the significant association of 911 with decreased time from collapse to call for help, decreased time to cardiopulmonary resuscitation (CPR), and decreased time to first shock (if in ventricular fibrillation [VF]). Younger age was significantly associated with survival in univariate analyses (8.94% versus 6.26% survival for younger versus older age groups, respectively), but this was not an independent association, which is indicated by the lack of significance of age in the multivariate model.
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Comparative Study
An evaluation of automated defibrillation and manual defibrillation by emergency medical technicians in a rural setting.
We show that automated external defibrillation training of emergency medical technicians (EMTs) is less time consuming than manual defibrillation training, and hypothesize that both improve survival from sudden cardiac death. Data on 91 cardiac arrests over 27 months among five basic life support services was collected before EMT-defibrillation (EMT-D) training. Subsequently, seven BLS services were trained in EMT-D using either manual difibrillation or automated external defibrillation technology, and 55 sudden cardiac death patients were entered after training. ⋯ We recommend automated external defibrillation training for EMTs. Improved survival in sudden cardiac death cases in well-run emergency medical service systems should result from EMT-D training. Finally, we recommend that routine "surveillance" of high-risk patients during transport by defibrillation-capable EMTs be considered in EMT-D programs, rather than limiting EMT-D only to units capable of rapid "man-down" response.