Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To analyze the accuracy of paramedic emergency medical services (EMS) dispatchers in predicting cardiac arrest and to assess the effect of the caller party on dispatcher accuracy in an advanced life support, public utility model EMS system, with greater than 90,000 calls and greater than 60,000 transports per year. ⋯ A higher level of medical training may improve dispatch accuracy for predicting cardiac arrest. The type of calling party influenced the PPV of dispatcher-assigned condition.
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To determine if there is an association between total out-of-hospital time and trauma patient mortality. ⋯ Provider-assigned CUPS status, patient age, Injury Severity Score, and Revised Trauma Score all were significant predictors of trauma patient mortality. Total out-of-hospital time was not associated with mortality.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized clinical trial of propofol versus methohexital for procedural sedation during fracture and dislocation reduction in the emergency department.
Although methohexital has been well studied for use in emergency department (ED) procedural sedation (PS), propofol has been evaluated less extensively for ED use. ⋯ The authors were unable to detect a significant difference in the level of subclinical RD or the level of sedation by BIS between the two agents. The use of either agent seems to be safe in the ED.
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Emergency department (ED) bedside echocardiography may offer useful information on cardiac function and volume status. The authors evaluated the accuracy of emergency physician (EP) performance of echocardiography in the assessment of left ventricular ejection fraction (LVEF) and central venous pressure (CVP). ⋯ Experienced EP sonographers with a small amount of focused additional training in limited bedside echocardiography can assess LVEF accurately in the ED.
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A multidisciplinary panel of experts is developing standardized reporting criteria for risk stratification studies of emergency department (ED) patients with potential acute coronary syndromes (ACS). The authors assessed the need for such criteria by reviewing published studies to determine whether these core criteria currently are being reported. ⋯ Many of the 47 items considered core criteria by the expert committee writing standardized reporting guidelines for risk stratification studies of potential ACS patients were not reported often in major cardiology and emergency medicine journals. There seems to be a need for standardized reporting guidelines because important information is not currently being reported.