The American journal of emergency medicine
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Randomized Controlled Trial
Improved sepsis bundles in the treatment of septic shock: a prospective clinical study.
Sepsis bundles can decrease mortality in patients with severe sepsis or septic shock. However, current methods of measuring pressure, such as central venous pressure, are inadequate. This study investigated the effect of improved sepsis bundles informed by pulse-indicated continuous cardiac output. ⋯ Pulse-indicated continuous cardiac output-directed sepsis bundles can reduce the severity of septic shock, provide more accurate fluid resuscitation, and reduce the duration of mechanical ventilation and stay in the intensive care unit.
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Randomized Controlled Trial Comparative Study
Video rigid flexing laryngoscope (RIFL) vs Miller laryngoscope for tracheal intubation during pediatric resuscitation by paramedics: a simulation study.
Endotracheal intubation (ETI) is an essential resuscitation procedure in children. Video laryngoscopes have been developed to avoid intubation failures in a variety of scenarios, including cardiopulmonary resuscitation. We hypothesized that the video laryngoscope RIFL (AI Medical Devices, Inc, Williamston, MI) offers advantages in the ETI of a pediatric manikin while performing chest compressions (CCs). ⋯ In simulated child arrest scenarios with normal/difficult airway conditions and with concomitant mechanical CC, paramedics performed better with the RIFL video laryngoscope than with the standard MIL.
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Over the last 20 years, numerous research articles and clinical guidelines aimed at optimizing resource utilization for emergency department (ED) patients presenting with syncope have been published. ⋯ Despite substantial efforts by medical researchers and professional societies, resource utilization associated with ED visits for syncope appears to have actually increased. There have been no apparent improvements in diagnostic yield for admissions. Novel strategies may be needed to change practice patterns for such patients.