The American journal of emergency medicine
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Review Case Reports
Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome.
Spontaneous retroperitoneal hematoma (SRH) is a severe and potentially fatal complication of anticoagulation therapy. We describe a case of fatal spontaneous massive retroperitoneal hematoma in a female patient receiving bridging therapy with enoxaparin for atrial fibrillation. ⋯ Computed tomographic scan is the imaging modality of choice for evaluating SRH. Early diagnosis and aggressive treatment are of paramount importance as SRH is associated with high mortality and morbidity rates.
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Randomized Controlled Trial
Push-fast recommendation on performing cardiopulmonary resuscitation causes excessive chest compression rates, a manikin model.
Increasing chest compression rate during cardiopulmonary resuscitation can affect the workload and, ultimately, the quality of chest compression. This study examines the effects of compression at the rate of as-fast-as-you-can on cardiopulmonary resuscitation (CPR) performance. ⋯ Push-fast technique showed a significant decrease in the percentile of effective chest compression compared with the 100-cpm technique during the 5-minute hand-only CPR. The PF technique exhibited a trend toward increased fatigue in the rescuers, which can result in early decay of CPR quality.
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Randomized Controlled Trial
Airway control in case of a mass toxicological event: superiority of second-generation supraglottic airway devices.
Early respiratory support and airway (AW) control with endotracheal intubation (ETI) are crucial in mass toxicology events and must be performed while wearing chemical personal protective equipment (C-PPE). ⋯ When compared with ETI, the use of SADs significantly shortened the time for AW control while wearing C-PPE. Second-generation SAD were superior to laryngeal mask AW unique. These finding suggest that SADs may be used in a mass toxicology event as a bridge, until definite AW control is achieved.
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Randomized Controlled Trial Comparative Study
Comparison of 3 different intraosseous access devices for adult during resuscitation. Randomized crossover manikin study.
The study was designed to investigate the success rate and time of insertion intraosseous access during simulated resuscitation. ⋯ The use of BIG is associated with excellent success rates for insertion and appears easier to use than EZ-IO or Jamshidi Intraosseus Needle. Further work to evaluate the use of the intraosseus access device in the emergency medical services is required.