Annals of emergency medicine
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Clinical Trial Controlled Clinical Trial
Biphasic transthoracic defibrillation causes fewer ECG ST-segment changes after shock.
Electrocardiographic abnormalities are common after transthoracic defibrillation. ECG ST-segment changes are especially problematic after defibrillation and may indicate ischemic or shock-induced cardiac dysfunction after resuscitation. Biphasic defibrillation waveforms, compared with monophasic waveforms, diminish shock-induced cardiac dysfunction in laboratory preparations. This effect has not been validated in human subjects. We therefore evaluated in a prospective, blinded fashion the effect of biphasic and monophasic transthoracic defibrillation on the ECG ST segment in 30 consecutive patients during surgery for the implantation of a cardioverter-defibrillator. ⋯ Transthoracic defibrillation with biphasic waveforms results in less postshock ECG evidence of myocardial dysfunction (injury or ischemia) than standard monophasic damped sine waveforms without compromise of defibrillation efficacy.
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We hypothesized that the addition of aminophylline to Advanced Cardiac Life Support (ACLS) interventions would improve the initial resuscitation success rate in an animal model of prolonged cardiac arrest. ⋯ Addition of aminophylline to standard ACLS interventions did not increase the incidence of ROSC or the 1-hour survival rate in a swine model of prolonged cardiac arrest.
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To determine the prevalence of domestic violence (DV) for male and female ED patients and to determine the demographics of DV. ⋯ Using a validated scale, we found that the prevalences of physical DV for men and women are high and that they are not statistically different in this population. Using chi 2 testing, we found that women had experienced significantly more past nonphysical violence than men; using logistic regression we found that they experienced significantly more nonphysical violence (both past and present) than men. DV was frequently associated with suicidal ideation, alcohol use, and family history of violence.