Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Randomized Controlled Trial
A new defibrillator mode to reduce chest compression interruptions for health care professionals and lay rescuers: a pilot study in manikins.
Chest compression interruptions are detrimental during the resuscitation of cardiac arrest patients, especially immediately prior to shock delivery. ⋯ Preshock pause time is reduced by 80% utilizing a novel technology that employs automated analysis and charging during chest compression. Although chest compression pause time is reduced with the use of the new technology, participants do not excessively fatigue.
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Randomized Controlled Trial
Direct versus video laryngoscopic intubation by novice prehospital intubators with and without chest compressions: A pilot manikin study.
To evaluate whether chest compressions affect the time taken for intubation (TTI) using the Macintosh laryngoscope and two portable video laryngoscopes (VLs) (GlideScope Ranger and Airway Scope) when used by novice prehospital caregivers, and to compare the TTIs and rates of successful intubation among the three laryngoscopes with and without chest compressions in a manikin model. ⋯ In this pilot study, chest compressions did not significantly affect the TTI using the Macintosh laryngoscope and two portable VLs when used by novice prehospital caregivers in the manikin model on the floor. Considering the fairly short training time, two portable VLs may be potentially useful adjuncts for tracheal intubation during chest compressions for novice prehospital caregivers. Further studies are required to validate whether these findings are clinically relevant.
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Randomized Controlled Trial
Comparison of bougie-assisted intubation with traditional endotracheal intubation in a simulated difficult airway.
To compare the success and ease of bougie-assisted intubation (BAI) with those of traditional endotracheal intubation (ETI) in a simulated difficult airway (20.4 seconds for BAI vs. 16.7 seconds for ETI, p = 0.102). ⋯ In a simulated difficult airway, BAI has a higher success rate than traditional ETI without increasing the time to successful intubation. Intubators perceive BAI as being easier to perform than traditional ETI in this simulated difficult airway scenario.
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Prehospital personnel rely on timely and accurate pulse oximetry data when performing critical skills, such as rapid-sequence intubation (RSI). However, loss of signal may be a frequent occurrence in patients with poor peripheral perfusion. In addition, a delay or latency period in the timeliness of pulse oximetry data may exist with probes placed on the fingers. ⋯ A high incidence of pulse oximetry failure was observed with the use of a digital pulse oximetry probe during prehospital RSI. In addition, a latent period appears to exist in the majority of patients undergoing desaturation.
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Abstract A case of prehospital anaphylactic shock that presented atypically, without a known exposure, is discussed. Anaphylaxis is a potentially life-threatening allergic reaction that requires prompt recognition and aggressive treatment. ⋯ These cases can be equally severe, with potentially fatal consequences if missed. The diagnosis and management of anaphylaxis are reviewed, as well as barriers that providers encounter in diagnosing uncommon presentations.