Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED). ⋯ Hypoglycemia in the pediatric seizure patient is extremely rare, thus universal field BGT has low utility and potential downstream effects. We propose a novel algorithm for the initial evaluation and management of prehospital pediatric seizures. Although limited to a retrospective analysis of a single medical center, our findings suggest the importance of reassessing prehospital seizure protocols. A larger patient sample should be studied to validate these findings and identify unique cases where glucose testing might be useful.
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We hypothesized that chest compressions located directly over the left ventricle (LV) would improve hemodynamics, including coronary perfusion pressure (CPP), and return of spontaneous circulation (ROSC) in a swine model of cardiac arrest. ⋯ In our swine model of cardiac arrest, chest compressions over the left ventricle improved hemodynamics and resulted in a greater proportion of animals with ROSC and survival to 60 minutes.