Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study Comparative Study
Emergency-department diagnosis of acute myocardial infarction and ischemia: a cost analysis of two diagnostic protocols.
To assess the potential cost savings of the emergency-department (ED) diagnosis of acute myocardial infarction (AMI) and other myocardial ischemia using a nine- hour ED evaluation protocol. ⋯ At both centers, hospital charges related to the acute evaluation of chest pain were significantly lower with this ED diagnostic protocol for AMI and myocardial ischemia.
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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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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.
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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.