Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Recovery from severe cyclic antidepressant overdose with hypertonic saline/dextran in a swine model.
To determine the effect of a hypertonic saline and dextran (HSD) solution on blood pressure and QS duration during severe cyclic antidepressant (CA) toxicity in swine. ⋯ In this swine model of severe CA toxicity, a solution of 7.5% saline/6% dextran significantly reversed hypotension and QRS prolongation. HSD also improved survival to 60 minutes.
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Randomized Controlled Trial Comparative Study Clinical Trial
In-vitro comparison of bag-valve-mask and the manually triggered oxygen-powered breathing device.
To determine whether tidal volume, intrapleural pressure, and gastric volume differ when the bag--valve-- mask (BVM) and the manually triggered oxygen powered breathing device (MTBD) are used in the settings of normal and decreased lung compliance. ⋯ In this model, tidal volumes and intrapleural pressures were similar for the two devices. When compliance was normal, no participant insufflated the stomach with the MTBD, while the gastric volume with BVM ventilation averaged 1.3 L. With decreased compliance, the MTBD again delivered significantly less gastric volume than the BVM (1.1 vs. 3.7 L, respectively). These findings favoring MTBD ventilation require corroboration in vivo.
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Multicenter Study
Emergency department CK-MB: a predictor of ischemic complications. National cooperative CK-MB project group.
To demonstrate that a positive CK-MB in the emergency department (ED) predicts an increased risk for complications of myocardial ischemia in patients admitted to the hospital for evaluation of chest pain. ⋯ Multicenter data support the hypothesis that CK-MB measurements can help risk-stratify ED chest pain patients whose initial ECGs are without diagnostic ST-segment elevation.
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To demonstrate that creatine kinase-MB fraction (CK-MB) elevations within three hours of presentation in the emergency department (ED) are associated with subsequent ischemic events in clinically stable chest pain patients. ⋯ An elevated CK-MB level within three hours of ED presentation is associated with a subsequent ischemic event in the clinically stable chest pain patient without ST-segment elevation. However, the ED CK-MB identifies only a minority or otherwise low-risk patients who develop ischemic events; other markers for diagnosing myocardial ischemia in the ED are needed.
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To determine the prevalence of substance use and alcohol abuse among emergency medicine residents. ⋯ Emergency medicine residents report a low rate of illicit substance use and do not appear to misuse alcohol differently than other housestaff. Interpretation of these results must be tempered with the potential for underreporting that may occur with a voluntary self-report survey of a sensitive nature.