European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Observational Study
Anaesthesiologist-provided prehospital airway management in patients with traumatic brain injury: an observational study.
Guidelines recommend that patients with brain trauma with a Glasgow Coma Scale (GCS) score of less than 9 should have an airway established. Hypoxia, hypotension and hypertension as well as hypoventilation and hyperventilation may worsen outcome in these patients. ⋯ The guideline adherence was high. The incidences of post-RSI hypoxia and systolic blood pressure below 90 compare with the results reported from other physician-staffed prehospital services. The incidence of systolic blood pressure below 120 as well as that of hyperventilation following prehospital endotracheal intubation in patients with traumatic brain injury call for a change in our current practice.
-
Review Case Reports
Heart failure with preserved ejection fraction: echocardiographic VALVE protocol for emergency physicians.
Heart failure with preserved ejection fraction, previously called diastolic heart failure, has been recognized to account for heart failure in about half the total population of patients with heart failure. These patients can present with the signs and symptoms of acute heart failure. ⋯ These findings can aid in the recognition of patients who present with heart failure with preserved ejection fraction. The authors will discuss a focused stepwise approach, namely the VALVE protocol, suitable for the fast-paced emergency department.
-
Randomized Controlled Trial Comparative Study
Quality of resuscitation by first responders using the 'public access resuscitator': a randomized manikin study.
The CAREvent Public Access Resuscitator (PAR) is an electronic, oxygen-driven cardiopulmonary resuscitation (CPR) device allowing volume-controlled ventilation with a face mask and guiding the rescuer through the resuscitation with voice prompts and visual indications. We hypothesized that 1 year after initial training, the efficacy of ventilation skills (primary outcome) and compression skills (secondary outcome) by first responders using the PAR would be superior compared with CPR with only a face mask. ⋯ Compared with the face mask, PAR improved tidal volume, compressions per minute and hand position in a manikin setting.