The American journal of emergency medicine
-
Randomized Controlled Trial
Child endotracheal intubation with a Clarus Levitan fiberoptic stylet vs Macintosh laryngoscope during resuscitation performed by paramedics: a randomized crossover manikin trial.
The main cause of cardiac arrest in pediatric patients is respiratory failure. ⋯ This study suggested that the FPS could be used as an option for airway management even for paramedics with little experience. Future studies should explore the efficacy of FPS in pediatric clinical emergency settings.
-
Observational Study
Lack of adverse effects from flumazenil administration: an ED observational study.
Flumazenil is an effective benzodiazepine (BZD) antagonist. Empiric use of flumazenil in the emergency department (ED) is not widely recommended due to concerns of seizures, which are commonly associated with coingestants and BZD withdrawal. ⋯ A majority of patients had improved mental status after the administration of flumazenil. No patient experienced seizures. Additional studies that clarify the role of flumazenil for ED patients with suspected BZD toxicity are warranted.
-
The objectives of this study are to describe an emergency department (ED) adult population with the chief complaint of mental and behavioral disorders due to psychoactive substance use and to investigate sex- and age-related differences. ⋯ Mental and behavioral disorders due to psychoactive substance use account for 1.3% of ED visits. Older people should be screened for chronic alcohol consumption. Our findings underscore the opportunity provided by the ED for screening and brief intervention in drug- and alcohol-related problems.
-
Observational Study
Risk-benefit analysis of lumbar puncture to evaluate for nontraumatic subarachnoid hemorrhage in adult ED patients.
The objective of the study is to compare the risks and benefits of lumbar puncture (LP) to evaluate for subarachnoid hemorrhage (SAH) after a normal head computed tomographic (CT) scan. ⋯ The yield of LP for diagnosing SAH in adults with nontraumatic headache after a normal head CT was very low. The severity of LP-related complications was low, but complications were more common than SAH diagnoses. Lumbar puncture may not be advisable after a normal head CT to evaluate for SAH, particularly in patients with low-risk clinical features for SAH.
-
Two common mass casualty triage algorithms are Simple Triage Algorithm and Rapid Treatment (START) and Sort, Assess, Lifesaving, Interventions, Treatment, and Transportation (SALT). We sought to determine the START and SALT efficacy in predicting clinical outcome by appropriate triage. ⋯ Overall, neither SALT nor START was sensitive or specific for predicting clinical outcome.