Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
CPR training and CPR performance: do CPR-trained bystanders perform CPR?
To determine factors associated with cardiopulmonary resuscitation (CPR) provision by CPR-trained bystanders and to determine factors associated with CPR performance by trained bystanders. ⋯ A minority of CPR-trained bystanders performed CPR. CPR provision was more common in CPR-trained bystanders with more than a high-school education and when CPR training had been within five years. Previously espoused reasons for not doing CPR (mouth-to-mouth, infectious-disease risk) were not the reasons that bystanders cited for not doing CPR. Further work is needed to maximize CPR provision after CPR training.
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Clinical Trial
The effect of a commercially available burn-cooling blanket on core body temperatures in volunteers.
Cooling of burns is one of the oldest therapies, yet there are concerns that excessive cooling may result in hypothermia. ⋯ The authors conclude that covering healthy volunteers with a room temperature burn-cooling blanket for 30 minutes does not result in hypothermia and that the cooling blanket reduces evaporative water loss.
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Older patients may visit the emergency department (ED) when their illness affects their function. ⋯ Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.
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Comparative Study Clinical Trial
Point-of-care test identifies diabetic ketoacidosis at triage.
Diabetic ketoacidosis (DKA) is a common, life-threatening complication of diabetes. The diagnosis of DKA relies on signs and symptoms, plus laboratory findings of blood glucose (BG) of > 250 mg/dL, an anion gap (AG) of > or = 15 mmol/L, and carbon dioxide (CO2) of < or = 18 mmol/L when other causes of acidosis are excluded. ⋯ The point-of-care test for beta-OHB was as sensitive as more established indicators of DKA. It is more useful than glucose alone for the diagnosis of DKA and offers immediate diagnosis of patients at triage.
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Randomized Controlled Trial
Laser-assisted anesthesia reduces the pain of venous cannulation in children and adults: a randomized controlled trial.
Application of topical anesthetics before intravenous (IV) cannulation is effective yet limited by delayed transdermal absorption. The authors evaluated a handheld laser device to enhance topical anesthetic absorption by ablating the stratum corneum, the major barrier to drug absorption through the skin. The hypothesis was that laser-assisted anesthesia would reduce the pain of IV cannulation in emergency department (ED) patients. ⋯ Pretreatment of the skin with a laser device followed by a five-minute topical lidocaine 4% application reduces the pain of IV cannulation in ED adult and pediatric patients.