Annals of emergency medicine
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Case Reports
Pacemaker-twiddler's syndrome: a rare cause of lead displacement and pacemaker malfunction.
Pacemaker-twiddler's syndrome is characterized by spontaneous, subconscious, inadvertent, or deliberate rotation of the pulse generator by the patient resulting in lead dislodgement and pacemaker malfunction. We present a case of pacemaker-twiddler's syndrome that involved an atrioventricular sequential pacemaker. It resulted in failure of atrial lead capture and phrenic nerve stimulation but without loss of ventricular lead capture. A search of the literature revealed only ten previous cases reported; none were in the emergency medicine literature, and none involved an atrioventricular sequential pacemaker.
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Randomized Controlled Trial Comparative Study Clinical Trial
Neuromuscular blockade-assisted oral intubation versus nasotracheal intubation in the prehospital care of injured patients.
To compare nasotracheal intubation (NTI) to neuromuscular blockade-assisted oral intubation (NMB-assisted oral intubation) in the prehospital care of injured patients. ⋯ In the prehospital management of severely injured patients, there is no significant difference between NMB-assisted oral intubation and NTI in the rate at which endotracheal intubation is achieved. However, practitioners may prefer NTI because it requires significantly less time to perform than NMB-assisted oral intubation.
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The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community.
To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest. ⋯ The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.
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To study the prevalence, risk factors, and consequences of ambulance diversion. ⋯ Ambulance diversion is a common and increasing event that delays emergency medical care.
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To determine characteristics motivating physicians to choose careers in academic and nonacademic emergency medicine. ⋯ Factors influencing career decisions can be used to plan strategies to meet the future needs of academic emergency medicine.