Can J Emerg Med
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The objective of this study was to determine the outcomes of women who presented to the emergency department (ED) with suspected ectopic pregnancy and received methotrexate as first-line treatment. ⋯ The proportion of patients failing methotrexate as first-line treatment was higher than previously reported. Further investigation is needed to determine whether methotrexate failure was due to non-adherence to recommended guidelines.
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Patients suffering from an out-of-hospital cardiac arrest (OHCA) associated with an initial shockable rhythm have a better prognosis than their counterparts. The implications of recurrent or refractory malignant arrhythmia in such context remain unclear. The objective of this study is to evaluate the association between the number of prehospital shocks delivered and survival to hospital discharge among patients in OHCA. ⋯ Survival remains possible even after a high number of shocks for patients suffering from an OHCA with an initial shockable rhythm. However, requiring more shocks is independently associated with worse survival.
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Observational Study
The practicalities and barriers of using TEG6s in code red traumas: an observational study in one London major trauma centre.
Trauma induced coagulopathy is a disorder of the coagulation pathway that occurs following major trauma. "Code red trauma" require massive hemorrhage protocol activation. The aim was to qualitatively establish the reasons TEG is not currently utilized and the ongoing practicalities in performing a TEG sample for trauma-related massive hemorrhage. ⋯ TEG6s samples can be run within the resuscitation department in a "code red trauma." However, there is a significant lack of knowledge relating to TEG within the emergency department which is likely to hinder its impact on personalized blood component management. More research is required in how to provide appropriate education in a busy setting to enable TEG to be utilized appropriately.