Annals of emergency medicine
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Review Meta Analysis
To Be Blunt: Are We Wasting Our Time? Emergency Department Thoracotomy Following Blunt Trauma: A Systematic Review and Meta-Analysis.
The role of emergency department (ED) thoracotomy after blunt trauma is controversial. The objective of this review is to determine whether patients treated with an ED thoracotomy after blunt trauma survive and whether survivors have a good neurologic outcome. ⋯ There may be a role for ED thoracotomy after blunt trauma, but only in a limited group of patients. Good outcomes have been achieved for patients who had vital signs on admission and for patients who received an ED thoracotomy within 15 minutes of cardiac arrest. The proposed guideline should be used to determine which patients should be considered for an ED thoracotomy, according to level 4 evidence.
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Randomized Controlled Trial
Randomized Controlled Trial of a Scoring Aid to Improve GCS Scoring by EMS Providers.
Emergency medical services (EMS) personnel frequently use the Glasgow Coma Scale (GCS) to assess injured and critically ill patients. This study assesses the accuracy of EMS providers' GCS scoring, as well as the improvement in GCS score assessment with the use of a scoring aid. ⋯ In this study, 60% of EMS participants provided inaccurate GCS score estimates. Use of a GCS scoring aid improved accuracy of EMS GCS score assessments.