Emergency medicine journal : EMJ
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Preventing and treating hypothermia in prehospital settings is crucial. Several products have been developed to prevent heat loss and actively warm patients in prehospital settings. We compared the efficacy and the surface temperature of different antihypothermia products, using a fluid-based model at two ambient temperatures. ⋯ At 20°C, HPMK and Ready-Heat-II increased fluid temperature in the model, while the other devices decreased heat loss. At 8°C, none of the tested devices increased the temperature. However, active heating devices prevented heat loss slightly better than passive methods. A protective insulation layer should be used with all active heating blankets.
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High-sensitivity cardiac troponin I (hs-cTnI) assays promise high diagnostic accuracy for myocardial infarction (MI). In an ED where conventional cTnI was in use, we evaluated an assessment pathway using the new Access hsTnI assay. ⋯ The novel pathway using the Access hsTnI assay has an acceptably low 30-day MACE rate.
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CT performed within 6 hours of headache onset is highly sensitive for the detection of subarachnoid haemorrhage (SAH). Beyond this time frame, if the CT is negative for blood, a lumbar puncture is often performed. Technology improvements in image noise reduction, resolution and motion artefact have enhanced the performance of multislice CT (MSCT) and may have further improved sensitivity. We aimed to describe how the sensitivity to SAH of modern MSCT changes with time from headache onset. ⋯ These data suggest that it may be possible to extend the timeframe from headache onset within which modern MSCT can be used to rule out aneurysmal SAH.