The American journal of emergency medicine
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Comparative Study
Accuracy of portable quantitative capnometers and capnographs under prehospital conditions.
This study was designed to assess the pCO(2) accuracy of portable mainstream (Tidal Wave, Novametrix; Propaq 106, Protocol) and sidestream capnometers (Capnocheck 8200, BCI; Capnocount mini, Weinmann; NPB-75, Nellcor Puritan Bennett; SC-210, Pryon) with respect to international standards and preclinical emergency conditions. Measurements were performed under temperature conditions of +22 degrees C and -20 degrees C using dry gas mixtures with different CO(2) concentrations (STPD) and in patients ventilated with pure oxygen (BTPS). ⋯ The measurements were affected by low ambient temperature only in the NPB-75 (+15%). Our results indicate that portable quantitative capnometers are able to fulfill accuracy requirements as requested by international standards but can be affected by changing ambient temperatures.
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We report 3 cases of myoclonus associated with etomidate during ED procedural sedation and analgesia (PSA). EPs should be familiar with myoclonus associated with etomidate. Clinicians using this drug for PSA should be prepared to offer the brief period of support, and occasionally, respiratory assistance, required when etomidate-associated myoclonus is encountered.
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The purpose of this study was to determine whether there is a lateralizing predisposition toward injury in right hand-dominant (RHD) individuals. The distal radius fracture was used as the injury for evaluation because it is easily defined and can be objectively documented by roentgenography. A prospective case-series design was used to include consecutive RHD patients with a distal radius fracture. ⋯ After adjustment for gender, the odds of developing a left compared with right distal radius fracture was 2.3-fold greater for the older compared with the younger age group (95% confidence interval, 1.0-5.2). Preliminary evidence suggests a lateralizing predisposition for left distal radius fractures in older compared with younger individuals who are RHD. If this data holds up, finding the etiology/mechanism of this predisposition might help in designing environments to minimize the impact of this injury pattern in the slightly older individual.