European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aims of this study were to examine sex differences in college students while they performed cardiopulmonary resuscitation (CPR) on a manikin for 20 min in (a) objective and subjective effort indicators and (b) to analyse the influence of potential confounders (age, BMI and cardiorespiratory fitness) on these sex differences. Sixty-three participants were recruited. ⋯ However, these sex differences disappeared when controlling for age, BMI and cardiorespiratory fitness. In conclusion, indicators of exertion during CPR are higher in women than in men, but these sex differences are because of BMI and differences in physical fitness conditions.
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Multicenter Study
Emergency medical services interval and mortality in significant head injury: a retrospective cohort study.
Recent interest has focused on reorganizing emergency medical services (EMS) for English traumatic brain injury (TBI) patients, with bypass of nonspecialist hospitals and direct transportation to distant neuroscience centres. This may expedite specialist neurocritical care and neurosurgical interventions, but risks harms from prehospital deterioration and delayed resuscitation. We therefore aimed to investigate the effect of EMS interval on outcome following head injury. ⋯ The lack of observed association between EMS interval and mortality may not preclude bypass of significant TBI patients, with concomitantly prolonged primary transfers from the scene of injury to distant specialist centres. However, given the limitations of registry data, our results should be interpreted with caution.
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Clinical Trial
Direct ultrasound methods: a confirmatory technique for proper endotracheal intubation in the emergency department.
Early confirmation of incorrect endotracheal tube (ETT) placement is of vital importance when performing emergency airway management. No ideal confirmation technique has been proposed under all circumstances. Recently, ultrasonography was suggested as a useful tool for confirmation of correct positioning of the ETT. The aim of this study is to assess the diagnostic accuracy of ultrasonography for detection of proper ETT placement. ⋯ In this study, we found acceptable sensitivity, specificity, positive predictive value, and negative predictive value for prediction of tracheal ETT placement with the use of dynamic and static ultrasonography.
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Noninvasive ventilation (NIV) is a common practice in acute hypercapnic respiratory failure (AHRF) because of exacerbation of chronic obstructive pulmonary disease (COPD). However, a recent study has shown that patients who require invasive mechanical ventilation (IMV) after failure of NIV experience high mortality rates (up to 30%). Therefore, the aim of this study is to determine the parameters, specifically for emergency department (ED) presentation, associated with the transition from NIV to IMV because of NIV failure. ⋯ Older age and a low Glasgow Coma Score at ED presentation are factors associated with the transition from NIV to IMV in COPD patients with AHRF.