Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Cardiac arrest is one of the leading causes of death in the United States and is treated by cardiopulmonary resuscitation (CPR). CPR involves both chest compressions and positive pressure ventilations when given by medical providers. Mechanical chest compression devices automate chest compressions and are beginning to be adopted by emergency medical services with the intent of providing high-quality, consistent chest compressions that are not limited by human providers who can become fatigued. Biosignals acquired from cardiac arrest patients have been characterized in their ability to track the effect of CPR on the patient. The authors investigated the feasibility and appropriate response of a biosignal-guided mechanical chest compression device in a swine model of cardiac arrest. ⋯ In this proof-of-concept study, a signal-guided chest compression device was demonstrated to be capable of responding to biosignal input and delivering chest compressions with a broad range of rates and depths.
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Changes in health care delivery and graduate medical education have important consequences for the workforce in pediatric emergency medicine (PEM). This study compared career preparation and potential attrition of the PEM workforce with the prior assessment from 1998. ⋯ While satisfaction with fellowship preparation for professional activities in PEM is improving, gaps remain in training in nonclinical skills. Symptoms of burnout are prevalent, and there is likely to be substantial attrition of PEM providers in the near future.
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The Broselow tape is a length-based tool used for the rapid estimation of pediatric weight and was developed to reduce dosage-related errors during emergencies. This study seeks to assess the accuracy of the Broselow tape and age-based formulas in predicting weights of South Sudanese children of varying nutritional status. ⋯ The Broselow tape and age-based formulas selected for comparison were all markedly inaccurate in both the nonmalnourished and the malnourished populations studied, worsening with increasing malnourishment. Additional studies should explore appropriate methods of weight and dosage estimation for populations of low- and low-to-middle-income countries and regions with a high prevalence of malnutrition.
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Review Meta Analysis
Effectiveness of Educational Interventions to Increase Primary Care Follow-up for Adults Seen in the Emergency Department for Acute Asthma: A Systematic Review and Meta-analysis.
Patients with asthma commonly present to emergency departments (ED) with exacerbations. Asthma guidelines recommend close follow-up with a primary care provider (PCP) after ED discharge; however, this linkage is often delayed or absent. The objective of this study was to assess whether ED-directed educational interventions improve office follow-up with PCPs after ED discharge for acute asthma. ⋯ ED-directed educational interventions targeting either patients or providers increase the chance of having office follow-up visits with PCPs after asthma exacerbations. Their impact on health-related outcomes (e.g., relapse and admissions) remains unclear.