Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Applying the trauma triage rule to blunt trauma patients.
To determine the accuracy of the Baxt Trauma Triage Rule (TTR: systolic blood pressure < 85 mm Hg; Glasgow Coma Scale-motor score < 5; or penetrating trauma to head, neck, or trunk) for prediction of major trauma in an independent data set of blunt trauma patients. ⋯ In this blunt trauma population, the Baxt TTR failed to identify a significant number of severely injured patients. Slight alterations in the definition of "major trauma" can significantly affect the performance characteristics of triage instruments.
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Comparative Study
Mock drug delivery to the proximal aorta during cardiopulmonary resuscitation: central vs peripheral intravenous infusion with varying flush volumes.
To compare mock drug deliveries to the proximal aorta during CPR after peripheral vs central i.v. administration when the mock drug is followed by different postinfusion flush volumes. ⋯ An adequately sized postinfusion crystalloid flush (0.5 mL/kg) permits peripherally administered model drug to reach the central circulation as quickly and in equivalent concentration as centrally administered drug during CPR in a canine cardiac arrest model.
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To describe ventilatory dynamics following the onset of ventricular fibrillation (VF) in an experimental swine model. ⋯ In this swine model, 11 of 12 (92%) continued to have spontaneous agonal respirations for the first 3 minutes of VF cardiac arrest. Many animals had supranormal tidal volumes, and near-normal minute ventilations. These findings have potential implications for lay-rescuer and first-responder contributions to resuscitation of victims of out-of-hospital cardiac arrest.
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Emergency services for disaster-affected populations require the application of out-of-hospital planning, curative acute medical skills, and public health principles. SAEM can play an important role in promoting the research and educational agendas for disaster medicine through its network of EM educators at academic health centers. ⋯ Postgraduate fellowships in disaster medicine also should be promoted and closely linked to disaster response organizations. Overall professional training must encompass the many facets described in this paper to prepare physicians to meet the challenges of disaster medicine.