European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Comparative Study
Instructor retraining and poster retraining are equally effective for the retention of BLS and AED skills of lifeguards.
More than a million people in the USA and Europe suffer a sudden cardiac arrest each year. Thousands of people have to be trained in delivering help in such a situation. This cluster-randomized study compared two refresher training methods for basic life support and use of an automated external defibrillation: a traditional instructor-led course, and self-instruction by poster. ⋯ Refresher self-training by the use of a poster was as effective as, and more flexible than, scheduled, instructor-led refresher training.
-
Comparative Study
Targeted wire-guided chest tube placement: a cadaver study.
Chest tube thoracostomy is a standard procedure for pleural fluid and air drainage. The aim of this study is to compare the success rate of the targeted tube thoracostomy using two different techniques: a targeted wire-guided (TWG) technique and a classical surgical (CS) technique. ⋯ A higher success rate was achieved with the TWG than with the CS thoracostomy technique.
-
We included 685 consecutive previously healthy well appearing infants younger than 3 months with fever without known source admitted to an Emergency Department without routinely performing lumbar punctures (LP). LP was performed in 198 infants. Of these, 36 (18.1%) showed pleocytosis. ⋯ It is unnecessary to perform a LP routinely on infants over 1 month of age. The decision to perform the LP in previously healthy and well appearing infants with fever without known source attended by an experienced paediatric emergency physician can be individualized with no subsequent adverse outcomes. This approach may lead to under-diagnosing nonbacterial meningitis.
-
In accidental hypothermia, normal signs of death are unreliable. It is generally accepted that a lifeless person is beyond the limits of rescue if plasma potassium (P-potassium) is higher than10 mmol/l. However, the rate of increase in potassium or in other markers after cardiac arrest has not been carefully studied in hypothermic individuals. The aim of this animal study was to assess biochemical changes after anoxic circulatory arrest at hypothermia and at normothermia followed by external cooling. ⋯ This study shows that if cardiac arrest occurs before hypothermia is established, P-potassium increases quickly in contrast to the situation when hypothermia induces cardiac arrest. Thus, a low P-potassium in a hypothermic individual with cardiac arrest indicates that cardiac arrest occurred recently or was secondary to the hypothermic event.