Emergency medicine journal : EMJ
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To evaluate the immediate cardiac and cardiovascular effects of Taser X26 conducted electrical weapon (CEW) exposure in human volunteers, including heart rhythm, rate and blood pressure. ⋯ CEW exposure produced no detectable dysrhythmias and a statistically significant increase in heart rate. Overall, Taser CEW exposure appears to be safe and well tolerated from a cardiovascular standpoint in this population. This study increases the cumulative human subject experience of CEW exposure with continuous ECG monitoring and includes 28 full 5-s exposures.
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ILCOR recommend the use of therapeutic hypothermia (32-34 degrees C) for 12-24 h in unconscious adult patients with spontaneous circulation after cardiac arrest with a VF rhythm. Among various methods of inducing hypothermia, the rapid infusion of ice-cold intravenous fluid has been used. ⋯ As induced hypothermia should be started as soon as possible in eligible patients, crystalloids should be stored in a refrigerator.
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Etomidate is used widely for rapid sequence induction (RSI) of anaesthesia in the emergency department (ED) as a result of its relative cardiovascular stability. There is concern over possible adrenal suppression and also that outcomes could be worse than in patients given other induction drugs. This possible association has not been studied in ED patients undergoing RSI. ⋯ Induction drug was not related to patient outcome in this cohort of patients. The risks of developing hypotension and receiving a vasopressor at induction were greatest with propofol. Emergency physicians should choose an induction drug based on individual patient circumstances, rather than being solely concerned about adrenal suppression.
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Multicenter Study
Can undergraduate paramedic students accurately identify lung sounds?
The accurate identification of lung sounds during chest auscultation is a skill commonly used by healthcare clinicians, including paramedics, when assessing a patient's respiratory status. It is a necessary skill as it enables confirmation of a patient's respiratory condition and guides the paramedic to a provisional diagnosis and the implementation of appropriate management. The object of this study was to identify if undergraduate paramedic students from two Australian universities were able to interpret a variety of lung sounds accurately. ⋯ In this study undergraduate paramedic students from two Australian universities were found to be inaccurate at interpreting a variety of common lung sounds. The study has highlighted that a greater emphasis needs to be given to lung sound interpretation in undergraduate paramedic education programmes.
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The growing demand for inpatient beds in Singapore has led Tan Tock Seng Hospital to set up an observation medicine unit where patients are monitored and discharged within a 24-h period. ⋯ With patient satisfaction becoming increasingly important as an indicator of the quality of care in the present healthcare environment, doctors and nurses should seek to improve their communication with their patients so as to ensure that patients are satisfied and receive quality care.