Emergencias
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Randomized Controlled Trial Comparative Study
Intubation through 2 supraglottic airway device in cervical spine immobilization: a randomized trial of residents' use of the intubating laryngeal mask airway and the intubating laryngeal tube in manikins.
The aim of this study was to compare the intubating laryngeal mask (iLM) airway and the new intubating laryngeal tube (iLTS-D) in use by residents with minimal previous intubation experience during simulated conditions of reduced cervical spine mobility. ⋯ The new iLTS-D may be a good alternative to the iLMA because a patient can be intubated and successfully ventilated in less time. The rate of successful intubation is also better with the iLTS-D.
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To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport. ⋯ Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.
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Observational Study
Triage level assignment and nurse characteristics and experience.
To study the relation between nursing staff demographics and experience and their assignment of triage level in the emergency department. ⋯ We found that triage level assignments were related to age, experience, shift, and total number of patients triaged by a nurse.
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Sudden unexpected death in the young, though rare, is devastating for both the family and the community. Although only 1.3 to 8.5 cases of sudden cardiac death (SCD) occur per 100 000 young people, autopsy is often inconclusive. ⋯ Autopsy-negative SCD has been related to inherited arrhythmogenic causes such as long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, Wolff- Parkinson-White syndrome, and idiopathic ventricular fibrillation. The important question for the emergency physician is how SCD can be predicted and prevented in the young so that there is no need for an autopsy.
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Observational Study
Volume expansion and variation in hemodynamic parameters.
To assess correlations among variations in hemodynamic parameters during fluid volume loading. ⋯ The relationships between changes in hemodynamic parameters after fluid loading are complex and must be taken into account if fluids are infused during resuscitation.