Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Does advanced age matter in outcomes after out-of-hospital cardiac arrest in community-dwelling adults?
To assess whether advanced age is an independent predictor of survival to hospital discharge in community-dwelling adult patients who sustained an out-of-hospital cardiac arrest in a suburban county. ⋯ There was a twofold decrease in survival following out-of-hospital cardiac arrest to discharge in patients aged 80 or more when compared with the reference group in this suburban county setting. However, resuscitation for community-dwelling elders aged 65-89 is not futile. These data support that out-of-hospital resuscitation of elders up to age 90 years is not associated with a universal dismal outcome.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized controlled trial to assess decay in acquired knowledge among paramedics completing a pediatric resuscitation course.
Critical pediatric illness or injury occurs infrequently in out-of-hospital settings, making it difficult for paramedics to maintain physical assessment, treatment, and procedure skills. ⋯ Although intensive out-of-hospital pediatric education enhances knowledge, that knowledge rapidly decays. Emergency medical services programs need to find novel ways to increase retention and ensure paramedic readiness.
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The educational goal of emergency medicine (EM) programs has been to prepare its graduates to provide care for a diverse range of patients and presentations, including pediatric patients. ⋯ Emergency medicine residents are exposed to PEM primarily by rotating through a general ED, the PED, and the PICU, being proctored by PEM and EM attendings and attending EM lectures and EM M&M conferences. Areas that may merit further attention for pediatric emergency training include experience in areas of neonatal resuscitation, pediatric M&M, and specific pediatric electives. This survey highlights the need to describe current educational strategies as a first step to assess perceived effectiveness.
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To determine appropriateness of out-of-hospital interventions by emergency medical services (EMS) personnel on children with respiratory illnesses. ⋯ Emergency medical services personnel underutilized oxygen and medications and overutilized vascular access, phlebotomy, and cardiac monitoring in children with respiratory illness in this urban setting. Increasing patient age, transport times, and illness severity tend to increase the use of certain interventions, while contact with online medical direction seems to improve appropriate use of interventions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pretreatment of lacerations with lidocaine, epinephrine, and tetracaine at triage: a randomized double-blind trial.
Pretreatment of lacerations with topical anesthetics reduces the pain of subsequent anesthetic injection yet requires time. This study was conducted to determine the ability of triage nurses to identify lacerations necessitating closure and pretreat them with a topical anesthetic and to compare the pain levels of lidocaine injection in lacerations pretreated with LET (lidocaine 2%, epinephrine 1:1,000, tetracaine 2%) vs a placebo. ⋯ Application of LET by triage nurses is more effective than placebo in adequately anesthetizing simple lacerations in normal hosts and decreases the pain of local anesthetic infiltration.