The American journal of emergency medicine
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Comparative Study
A comparison of two techniques for tungsten carbide ring removal.
Emergency physicians may have difficulty removing modern rings made of hard metals such as titanium and tungsten carbide. These metals are exceptionally difficult or impossible to remove using standard ring cutters. Numerous alternative techniques for removal have been described, including the "umbilical tape" or "string technique" and, in the case of tungsten carbide, breaking the ring using locking pliers. ⋯ Both the umbilical tape or string technique and the locking pliers technique successfully removed tungsten carbide rings in our model. The locking pliers technique is significantly faster but destroys the ring and creates potentially harmful shrapnel.
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Review Meta Analysis Comparative Study
Biphasic versus monophasic defibrillation in out-of-hospital cardiac arrest: a systematic review and meta-analysis.
Biphasic defibrillation is more effective than monophasic one in controlled in-hospital conditions. The present review evaluated the performance of both waveforms in the defibrillation of patients of out-of-hospital cardiac arrest (OHCA) with initial ventricular fibrillation (Vf) rhythm under the context of current recommendations for cardiopulmonary resuscitation. ⋯ Biphasic waveforms did not seem superior to monophasic ones with respect to Vf termination, ROSC, or survival to hospital discharge in OHCA patients with initial Vf rhythm under the context of current guidelines. However, most trials were conducted in accordance with previous guidelines for cardiopulmonary resuscitation. Therefore, further trials are needed to clarify this issue.
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To determine whether frequent emergency department (ED) users are more likely to make at least one and a majority of visits for mental health, alcohol, or drug-related complaints compared to non-frequent users. ⋯ Frequent ED users were more likely to make a mental health, alcohol or drug-related visit, but a majority of visits were only noted for those with alcohol-related diagnoses. To address frequent ED use, interventions focusing on managing patients with frequent alcohol-related visits may be necessary.
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Many patients discharged from the emergency department (ED) require urgent follow-up with specialty providers. We hypothesized that a unique specialty referral mechanism that minimized barriers would increase follow-up compliance over reported and historical benchmarks. ⋯ A referral process that minimizes barriers can achieve an 80% follow-up compliance rate. Age, insurance, specialty type, and time to appointment are associated with noncompliance.
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Randomized Controlled Trial
One-hand chest compression and hands-off time in single-lay rescuer CPR-a manikin study.
To evaluate the effect of one-hand chest compression while continuously maintaining an open airway (OCOA) on rescue breath-associated hands-off time (RAHO) during single-lay rescuer cardiopulmonary resuscitation (CPR). ⋯ In our study, OCOA resulted in shorter RAHO and less stomach inflation. Our results indicate that the airway should be maintained open during chest compressions, regardless of the technique. Larger studies are needed for the full clarification of OCOA.