The American journal of emergency medicine
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Chest compressions are pivotal determinants of successful resuscitation. The aim of our study was to identify the variations of the anatomical structures underneath the sternum and to investigate possible implications for chest compressions. ⋯ The occurrence of cardiac chambers under the lower part of the sternum is very high, making it a reasonable position for hand placement during chest compressions. However, optimal hand position may differ with age and among healthy individuals owing to variations in thoracic anatomy.
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Randomized Controlled Trial Comparative Study
A randomized open-label study of sodium valproate vs sumatriptan and metoclopramide for prolonged migraine headache.
The objective of this study is to compare the efficacy and tolerability of intravenous valproic acid (iVPA) with intramuscular metoclopramide + subcutaneous (SQ) sumatriptan for prolonged acute migraine. ⋯ Treatment with iVPA was more effective than metoclopramide + SQ sumatriptan during the first 2 hours in patients with a prolonged migraine.
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Clinical Trial
Effect of physical fatigue on the quality CPR: a water rescue study of lifeguards: physical fatigue and quality CPR in a water rescue.
The purpose of the study is to analyze the influence of the fatigue caused by a water rescue on the cardiopulmonary resuscitation (CPR) performance. ⋯ The accumulated fatigue during a water rescue performed by lifeguards reduces the quality of chest compressions and ventilations on the CPR.
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The objective of this study was to evaluate the effectiveness of a streamlined interfacility referral protocol in reducing door-to-balloon (D2B) times for patients experiencing acute ST-segment elevation myocardial infarction (STEMI). ⋯ The implementation of a streamlined referral protocol has significantly reduced D2B times for patients diagnosed with STEMI that required interfacility transport for intervention.
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Randomized Controlled Trial Comparative Study
A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation.
The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound. ⋯ The longitudinal method of visualizing the axillary vein during ultrasound-guided venous access is associated with greater first-attempt success, fewer needle redirections, and a trend of fewer arterial punctures compared with the transverse orientation.