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Emergency Department

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973 papers 1000+ followers All things emergency medicine. All things good.
By David Hedman Anesthesia
https://www.readbyqxmd.com/read/27749553/preoxygenation-using-invasive-ventilator-in-volume-control-mode-in-patients-with-emergency-intubation-can-shorten-the-time-of-preoxygenation-and-improve-the-quality-of-preoxygenation-a-retrospective-study
#1
Hai Wang, Jiang-Li Sun, Zheng-Hai Bai, Xiao-Bo Wang, Zheng-Liang Zhang, Hong-Hong Pei
Preoxygenation can rapidly improve oxygenation and enhance the security of endotracheal intubation, so it is very essential before endotracheal intubation. The conventional preoxygenation method self-inflating bag (SIB) is not very effective in case of emergency. So our study aims to find a more effective method of preoxygenation in a critical situation.We retrospectively analyzed data of 105 patients in this study. A total of 49 patients with preoxygenation with invasive ventilator in volume control mode (VCM) and 56 patients with preoxygenation with SIB were included...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27797983/efficacy-of-various-types-of-laryngoscope-direct-pentax-airway-scope-and-glidescope-for-endotracheal-intubation-in-various-cervical-immobilisation-scenarios-a-randomised-cross-over-simulation-study
#2
Jong Won Kim, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Sang O Park
OBJECTIVE: To compare the efficacy of direct laryngoscopy (DL), Pentax Airway Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal intubation (ETI) in various cervical immobilisation scenarios: manual in-line stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth opening) and Stifneck collar (SNC) (severe limit of mouth opening). DESIGN: Randomised cross-over simulation study. SETTING AND PARTICIPANTS: 35 physicians who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27825693/use-of-nitroglycerin-by-bolus-prevents-intensive-care-unit-admission-in-patients-with-acute-hypertensive-heart-failure
#3
Suprat Saely Wilson, Gregory M Kwiatkowski, Scott R Millis, John D Purakal, Arushi P Mahajan, Phillip D Levy
OBJECTIVES: The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both. METHODS: We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89)...
October 18, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27366551/influence-of-different-doses-of-ketamine-on-intubating-conditions-during-a-rapid-sequence-induction-and-intubation-model
#4
Başak Ceyda Meço, Ahmet Onat Bermede, Zekeriyya Alanoğlu, Olcay Yaka, Neslihan Alkış
OBJECTIVE: This prospective, randomized, double-blinded study aimed to compare the effects of three different doses of ketamine or lidocaine on intubating conditions and haemodynamics in a rapid-sequence induction model with 3 mg kg(-1) propofol and 0.6 mg kg(-1) rocuronium. METHODS: A total of 128 ASA I-III patients who were scheduled for elective surgery were randomized in the following five groups: Group 1 (n=24), 1 mg kg(-1) lidocaine+3 mg kg(-1) propofol+0...
February 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/26866753/head-elevated-patient-positioning-decreases-complications-of-emergent-tracheal-intubation-in-the-ward-and-intensive-care-unit
#5
MULTICENTER STUDY
Nita Khandelwal, Sarah Khorsand, Steven H Mitchell, Aaron M Joffe
BACKGROUND: Based on the data from elective surgical patients, positioning patients in a back-up head-elevated position for preoxygenation and tracheal intubation can improve patient safety. However, data specific to the emergent setting are lacking. We hypothesized that back-up head-elevated positioning would be associated with a decrease in complications related to tracheal intubation in the emergency room environment. METHODS: This retrospective study was approved by the University of Washington Human Subjects Division (Seattle, WA)...
April 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27090535/a-deliberately-restricted-laryngeal-view-with-the-glidescope%C3%A2-video-laryngoscope-is-associated-with-faster-and-easier-tracheal-intubation-when-compared-with-a-full-glottic-view-a-randomized-clinical-trial
#6
Yuqi Gu, Joshua Robert, George Kovacs, Andrew D Milne, Ian Morris, Orlando Hung, Kirk MacQuarrie, Sean Mackinnon, J Adam Law
INTRODUCTION: During video laryngoscopy (VL) with angulated or hyper-curved blades, it is sometimes difficult to complete tracheal intubation despite a full view of the larynx. When using indirect VL, it has been suggested that it may be preferable to obtain a deliberately restricted view of the larynx to facilitate passage of the endotracheal tube. We used the GlideScope® GVL video laryngoscope (GVL) to test whether deliberately obtaining a restricted view would result in faster and easier tracheal intubation than with a full view of the larynx...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27110526/effect-of-etomidate-versus-combination-of-propofol-ketamine-and-thiopental-ketamine-on-hemodynamic-response-to-laryngoscopy-and-intubation-a-randomized-double-blind-clinical-trial
#7
Afshin Gholipour Baradari, Abolfazl Firouzian, Alieh Zamani Kiasari, Mohsen Aarabi, Seyed Abdollah Emadi, Ali Davanlou, Nima Motamed, Ensieh Yousefi Abdolmaleki
BACKGROUND: Laryngoscopy and intubation frequently used for airway management during general anesthesia, is frequently associated with undesirable hemodynamic disturbances. OBJECTIVES: The aim of this study was to compare the effects of etomidate, combination of propofol-ketamine and thiopental-ketamine as induction agents on hemodynamic response to laryngoscopy and intubation. PATIENTS AND METHODS: In a double blind, randomized clinical trial a total of 120 adult patients of both sexes, aged 18 - 45 years, scheduled for elective surgery under general anesthesia were randomly assigned into three equally sized groups...
February 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27107688/a-quantitative-comparison-of-physiologic-indicators-of-cardiopulmonary-resuscitation-quality-diastolic-blood-pressure-versus-end-tidal-carbon-dioxide
#8
Ryan W Morgan, Benjamin French, Todd J Kilbaugh, Maryam Y Naim, Heather Wolfe, George Bratinov, Wesley Shoap, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP vs. ETCO2 during CPR as predictors of cardiac arrest survival. METHODS: In two models of cardiac arrest (primary ventricular fibrillation [VF] and asphyxia-associated VF), 3-month old swine received either standard AHA guideline-based CPR or patient-centric, BP-guided CPR...
July 2016: Resuscitation
https://www.readbyqxmd.com/read/27130846/when-is-an-expert-truly-an-expert
#9
Melanie Heniff
No abstract text is available yet for this article.
October 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26602425/lidocaine-induced-cardiac-arrest-in-the-emergency-department-effectiveness-of-lipid-therapy
#10
Kevin James Tierney, Tiffany Murano, Brenda Natal
BACKGROUND: Local anesthetics are commonly used in the emergency department (ED). Overdoses can lead to disastrous complications including cardiac toxicity and arrest. Recognition of local anesthetic systemic toxicity (LAST) is important; however, prevention is even more critical. Knowledge of proper lidocaine dosage can prevent LAST. LAST may be effectively treated with lipid emulsion therapy. Although the mechanism is not well understood, its use may have a profound impact on morbidity and mortality...
January 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26237037/vasopressors-for-the-treatment-of-septic-shock-systematic-review-and-meta-analysis
#11
REVIEW
Tomer Avni, Adi Lador, Shaul Lev, Leonard Leibovici, Mical Paul, Alon Grossman
OBJECTIVE: International guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents. Our objective was to assess the evidence for the efficiency and safety of all vasopressors in septic shock. METHODS: Systematic review and meta-analysis. We searched electronic database of MEDLINE, CENTRAL, LILACS and conference proceedings up to June 2014...
2015: PloS One
https://www.readbyqxmd.com/read/26263297/arterial-blood-pressure-and-heart-rate-regulation-in-shock-state
#12
REVIEW
Jeffrey D DellaVolpe, Jason E Moore, Michael R Pinsky
PURPOSE OF REVIEW: Circulatory shock is a complicated problem that carries a high risk of complications and mortality for critically ill patients. The heart rate and blood pressure targets to which a patient in shock should be resuscitated remain a challenge to intensivists. RECENT FINDINGS: While the ideal blood pressure and heart rate in circulatory shock are still not definitive, recent studies have begun to refine these targets. A recent trial comparing a mean arterial pressure target of 80-85 mmHg with a target of 65-70 mmHg showed no difference in mortality, with a decreased need for renal replacement therapy in patients with pre-existing hypertension based on subgroup analysis...
October 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26205599/the-early-repolarization-pattern-a-consensus-paper
#13
REVIEW
Peter W Macfarlane, Charles Antzelevitch, Michel Haissaguerre, Heikki V Huikuri, Mark Potse, Raphael Rosso, Frederic Sacher, Jani T Tikkanen, Hein Wellens, Gan-Xin Yan
The term early repolarization has been in use for more than 50 years. This electrocardiographic pattern was considered benign until 2008, when it was linked to sudden cardiac arrest due to idiopathic ventricular fibrillation. Much confusion over the definition of early repolarization followed. Thus, the objective of this paper was to prepare an agreed definition to facilitate future research in this area. The different definitions of the early repolarization pattern were reviewed to delineate the electrocardiographic measures to be used when defining this pattern...
July 28, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26210381/can-vasopressors-safely-be-administered-through-peripheral-intravenous-catheters-compared-with-central-venous-catheters
#14
EDITORIAL
J Michael Brewer, Michael A Puskarich, Alan E Jones
No abstract text is available yet for this article.
December 2015: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26233619/assessment-of-acute-asthma-severity-in-the-ed-are-heart-and-respiratory-rates-relevant
#15
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Assessment of acute asthma severity in the emergency department (ED) determines the appropriate initial therapy. The aim of this study was to evaluate the usefulness of heart and respiratory rates as determinants of severity of asthma exacerbations. METHODS: It was a pooled analysis of individual patient data from different controlled clinical trials performed over a 9-year period. The sample was characterized by patients with a diagnosis of asthma, age 18 to 50 years, and a forced expiratory volume in the first second (FEV1) or a peak expiratory flow less than or equal to 50% of predicted at ED presentation...
November 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26234585/preferences-of-air-blood-saline-sonographic-microbubble-contrast-agents-among-emergency-medicine-resident-physicians
#16
Michael Doctor, Sebastian D Siadecki, Gabriel Rose, Rachel Berkowitz, Danielle Matilsky, Turandot Saul
INTRODUCTION: The placement of a central venous catheter (CVC) remains an important intervention in the care of critically ill patients in the emergency department, and bedside ultrasound can be used for procedural guidance as well as conformation of placement. Microbubble contrast-enhanced ultrasound may facilitate CVC tip position localization, and the addition of autologous blood can significantly increase its echogenicity. The purpose of this study was to describe the preferences of a group of resident physicians regarding the performance of various concentrations of air-blood-saline sonographic microbubble contrast agents...
October 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26235993/what-is-the-yield-of-testing-for-coronary-artery-disease-after-an-emergency-department-attendance-with-chest-pain
#17
Anne-Maree Kelly, Sharon Klim
BACKGROUND: Guidelines recommend testing for coronary artery disease (CAD) for emergency department (ED) patients with a negative workup for acute coronary syndrome (ACS). The rationale is that, although myocardial infarction has been ruled out, the presentation could still indicate cardiac ischaemia. Evidence supporting this recommendation is weak. METHODS: Planned sub-study of prospective cohort study of ED chest pain patients with a negative ACS workup who were discharged...
January 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/26045965/mechanical-ventilation-of-acute-respiratory-distress-syndrome
#18
REVIEW
Ryoichi Ochiai
Acute respiratory distress syndrome (ARDS) has been intensively and continuously studied in various settings, but its mortality is still as high as 30-40 %. For the last 20 years, lung protective strategy has become a standard care for ARDS, but we still do not know the best way to ventilate patients with ARDS. Tidal volume itself does not seem to have an important role to develop ventilator-induced lung injury (VILI), but the driving pressure, which is inspiratory plateau pressure-PEEP, is the most important to predict and affect the outcome of ARDS, though there is no safe limit for the driving pressure...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26209466/novel-vagal-maneuver-technique-for-termination-of-supraventricular-tachycardias
#19
Haluk Un, Mehmet Dogan, Omer Uz, Zafer Isilak, Mehmet Uzun
Hemodynamically unstable patients with supraventricular tachycardias (SVTs) should be treated with electrical cardioversion. If the patient is stable, acute termination of tachycardia can be achieved by vagal maneuvers or medical therapy. The Valsalva maneuver, carotid massage, and ice to the face are the most common vagal maneuvers. In our experience with patients, we observed that vagal stimulation increases with lying backward. Our suggested maneuver is based on quickly lying backward, from a seated position...
January 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26218689/intravenous-access-in-the-prehospital-settings-what-can-be-learned-from-point-of-injury-experience
#20
Roy Nadler, Sami Gendler, Avi Benov, Avi Shina, Erez Baruch, Gilad Twig, Elon Glassberg
BACKGROUND: Intravenous (IV) access has an essential role in the care provided for trauma patients, allowing for transfusion of blood products, fluids, and drugs. Decisions should be made regarding the necessity of IV access while considering cost-benefit of the procedure in terms of delayed evacuation times. METHODS: A retrospective review of all trauma patients in whom at least one attempt at IV access was performed were reviewed. Data were abstracted from the Israeli Defense Force Trauma Registry...
August 2015: Journal of Trauma and Acute Care Surgery
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