Annals of emergency medicine
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To assess whether bystander CPR (BCPR) on collapse affects initial rhythm and outcome in patients with witnessed, unmonitored out-of-hospital cardiac arrest (OHCA). ⋯ Patients who receive BCPR are more often found in VT/VF and have an increased rate of live discharge, with controls for age and response and definitive care intervals. For VT/VF patients, BCPR is associated with an increased rate of live discharge.
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End-tidal CO2 (ETCO2) measurement can be used to predict death in prehospital cardiac arrest patients with pulseless electrical activity (PEA). ⋯ This study suggests that a low ETCO2 (10 mm Hg or less) can be used to predict irreversible death in patients with pulseless electrical activity undergoing prehospital advanced cardiac life support. If future studies validate this model, use of ETCO2 may allow for triage decisions in the field.
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To describe emergency department quality assurance (QA)/improvement (QI) practices for pediatric patients. ⋯ The bulk of pediatric emergency patients are cared for in a general ED. Most ACEP members surveyed reported the use of separate QA indicators to monitor the care of pediatric patients seen in the ED. This survey provides the first description of QA/QI practices for pediatric patients by EDs nationwide.
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To determine the prevalence of abnormal computed tomography (CT) scans and define high-risk clinical variables in patients with mild head injury. ⋯ Abnormalities on CT scans in patients with mild head trauma are fairly common, although the need for neurosurgical intervention is rare. Clinical decision rules can be used to identify those patients with more serious intracranial pathology. Such strategies should be validated prospectively in various ED settings.
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To assess the prognostic value of initial end-tidal CO2 pressures (PETCO2) during CPR in patients with out-of-hospital cardiac arrest (OHCA). ⋯ In this observation study of 27 patients, initial PETCO2 during CPR with automated ventilation was prognostic for ROSC in patients with OHCA. Patients with ROSC have higher PETCO2 values after 1 and 2 minutes than do patients without ROSC.