J Emerg Med
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Randomized Controlled Trial Multicenter Study
A Multicenter, Prospective Study Comparing Subxiphoid and Parasternal Views During Brief Echocardiography: Effect on Image Quality, Acquisition Time, and Visualized Anatomy.
Recent literature has suggested echocardiography (echo) may prolong pauses in chest compressions during cardiac arrest. ⋯ Echo was performed in < 10 s in > 50% of patients using either imaging technique. Imaging using PSL demonstrated improved image quality and improved identification of cardiac landmarks.
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Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to temporarily control bleeding and maintain the cerebral and coronary blood flow in cases in which it is difficult to control hemorrhagic shock. However, the safety and effectiveness of REBOA remains uncertain. ⋯ According to the results of this study, in trauma patients who undergo REBOA catheter placement, the presence of aortic occlusion was not significantly associated with 30-day mortality. Furthermore, the performance of aortic occlusion was not associated with a significant increase in complications.
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Patients with severe agitation are frequently encountered in the emergency department (ED). At times, these patients are physically restrained and given calming medications; however, little is known about the effects of medications and other predictors on restraint duration. ⋯ Restraint duration of agitated ED patients was similar when haloperidol or ziprasidone was used as the primary antipsychotic. However, race and additional medications given during restraint were significantly associated with restraint duration.
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Traumatic asphyxia is a syndrome caused by a sudden pressure rise in the chest caused by crushing injury of the thorax or upper abdomen. It is associated with a variety of thoracic injuries, neurological symptoms, and ocular complications. ⋯ We report an unusual case of traumatic asphyxia complicated by severe, sight-threatening, elevation in intraocular pressure. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: After initial stabilization, the treatment of patients with traumatic asphyxia is supportive and is mainly directed toward the accompanying injuries and complications. A complete and prompt ophthalmologic examination, including tonometry, should be an integral part of the secondary survey. This is particularly important in patients who cannot report visual impairment, such as children or unconscious patients.
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Professionals working in the emergency department (ED) are regularly exposed to traumatic events. Rates of posttraumatic mental health conditions vary widely in the literature and there is no agreement that rates in ED staff are elevated relative to other populations. ⋯ ED professionals have an elevated risk of experiencing PTSD, depression, and anxiety. Identification of organizational and workplace predictors are needed to inform interventions that will reduce risk and provide optimal treatment and management of PTSD, depression, and anxiety in ED settings.