Annals of emergency medicine
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Of all child visits to emergency departments, 1% to 5% involve critically ill children who require cardiopulmonary resuscitation. Numerous versions of pediatric equipment lists for EDs have been published. Despite these efforts, many EDs remain unprepared for pediatric emergencies. The objectives of this study were to assess the availability of pediatric resuscitation equipment items in Canadian hospital EDs and to identify risk factors for the unavailability of these items. ⋯ This study demonstrated that essential pediatric resuscitation equipment is unavailable in a disturbingly high number of EDs across Canada and has identified several determinants of this unavailability.
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Dizziness is a frequent presenting complaint in emergency department patients. Although seen in patients of all ages, it is more prevalent in patients older than 50 years of age. ⋯ The illusion of motion may be of oneself (subjective vertigo) or of external objects (objective vertigo). The emergency physician should consider a large differential in the evaluation of vertigo with special attention to whether the vertigo is central or peripheral in origin.
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Practice Guideline Guideline
Action sequence for layperson cardiopulmonary resuscitation.
Although some minor modifications were forged, the general consensus was to maintain most of the current guidelines for phone first/phone fast, no-assisted-ventilation CPR, the A-B-C (vs C-A-B) sequence of CPR, and the recovery position. The decisions to leave these guidelines as they are were based on a lack of evidence to justify the proposed changes, coupled with a reluctance to make revisions that would require major changes in worldwide educational practices without such evidence. Nonetheless, some major changes were made. ⋯ Likewise, it was recommended that even the professional rescuer now check for these other signs of circulation. Although professional rescuers may simultaneously check for a pulse, they should do so only for a short period of time (within 10 seconds). There was also enthusiasm for deleting the ventilation aspect of EMS dispatcher-assisted CPR instructions that are provided to rescuers at the scene who are inexperienced in CPR. lt was made clear, though, that the data are applicable only to adult patients who are receiving CPR and that the data are appropriate most for EMS systems with rapid response times.
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Practice Guideline Guideline
Chest compressions and basic life support-defibrillation.