The American journal of emergency medicine
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Multicenter Study
Practice variation in neuroimaging to evaluate dizziness in the ED.
The appropriate role of neuroimaging to evaluate emergency department (ED) patients with dizziness is not established by guidelines or evidence. ⋯ The use of neuroimaging for ED patients with dizziness varies substantially without an associated improvement in stroke diagnosis, which is identified only rarely.
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Review Comparative Study
Cardiocerebral resuscitation vs cardiopulmonary resuscitation for cardiac arrest: a systematic review.
The objective of this study is to evaluate the efficacy of cardiocerebral resuscitation (CCR) vs cardiopulmonary resuscitation (CPR) for patients with out-of-hospital cardiac arrest (OHCA). ⋯ Cardiocerebral resuscitation might be equivalent or superior to CPR in patients with OHCA in both survival rate and neurologic benefits. Further work is needed to assess the efficacy of CCR for victims who had OHCA of noncardiac causes.
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Therapeutic hypothermia (TH) has gained popularity as a brain-protective strategy for victims of sudden cardiac death in whom return of spontaneous circulation has been achieved but coma persists. Trials have also demonstrated some advantageous effects of lowering core body temperature after stroke and hypoxic-ischemic encephalopathy of the newborn. In a variety of clinical conditions, TH is still being studied (eg, hepatic encephalopathy and traumatic brain injury). This study describes the historical development of TH, its current applications in emergency medicine, and its potential future uses.
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Medication errors are a common cause of iatrogenic adverse drug events. The incidence and nature of medication errors during prehospital treatment have not been fully described. ⋯ More medication errors occur in the ED than in the emergency vehicles. Patients treated with multiple medications are more prone to medication errors.
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Unintentional, non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the United States, but the overall hospital burden is unknown. This study presents patient characteristics and the most recent comprehensive national estimates of UNFR CO-related emergency department (ED) visits and hospitalizations. ⋯ Unintentional, non-fire-related CO poisonings pose significant economic and health burden; continuous monitoring and surveillance of CO poisoning are needed to guide prevention efforts. Public health programs should emphasize CO alarm use at home as the main prevention strategy.