The American journal of emergency medicine
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Randomized Controlled Trial
Comparison of chest compression kinematics associated with over-the-head and standard cardiopulmonary resuscitation.
Over-the-head cardiopulmonary resuscitation (CPR) is a method of chest compression, which may be easier to perform than standard CPR in a confined space. ⋯ There were no differences between the kinematics, compression forces, depths, and frequencies obtained using the O and S CPR methods as practiced by experienced providers.
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Controlled Clinical Trial
A better way to estimate adult patients' weights.
In the emergency department (ED), adult patients' weights are often crudely estimated before lifesaving interventions. In this study, we evaluate the reliability and accuracy of a method to rapidly calculate patients' weight using readily obtainable anthropometric measurements. We compare this method to visual estimates, patient self-report, and measured weight. ⋯ This technique using readily obtainable measurements estimates weight more accurately than ED providers. The technique correlates well with actual patient weights. When available, patient estimates of their own weight are most accurate.
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Case Reports
Delayed salicylate toxicity with undetectable initial levels after large-dose aspirin ingestion.
Aspirin (acetylsalicylic acid), the most commonly used medicinal salicylate, is an antiinflammatory, antipyretic, antirheumatic, and analgesic agent. In 2005, according to the Toxic Exposures Survey from the American Association of Poison Control Centers' National Poisoning and Exposure Database, there were more than 20,000 reported aspirin and nonaspirin salicylate exposures, 64% of which required treatment in a health care facility. Of these exposures, 50% were reported as intentional overdoses and 60 patients died.
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The objective was to assess agreement between end-tidal carbon dioxide values measured by a handheld capnometer (Petco(2)) and values measured by a blood gas analyzer (Paco(2)) in nonintubated patients with respiratory distress in an out-of-hospital setting. ⋯ Petco(2) measurements poorly reflected Paco(2) values in our population of nonintubated patients with respiratory distress of various origins.
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Hemodynamics after intraosseous administration of hydroxocobalamin or normal saline in a goat model.
Hydroxocobalamin may be lifesaving in cyanide (CN) poisoning, but personal protective equipment (PPE) wear, rescue, and decontamination may delay intravenous administration. Intraosseous (IO) lines may be rapidly placed even when wearing PPE. We assessed the hemodynamics of hydroxocobalamin (OHCo) and normal saline (NS) by the IO route. ⋯ Hemodynamic effects of OHCo given by the IO route in non-CN-poisoned goats are mild and well tolerated. Increases in mean blood pressure at peak after baseline were greater in the NS group, but the mean values over time were not significantly different from those observed in the OHCo group. Hemodynamic effects would likely differ somewhat in a CN-poisoned goat. Intraosseous OHCo administration warrants additional investigation.