The American journal of emergency medicine
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Randomized Controlled Trial Comparative Study
Inhaled corticosteroids increase blood neutrophil count by decreasing the expression of neutrophil adhesion molecules Mac-1 and L-selectin.
The objective was to investigate the effect of commonly used inhaled corticosteroids on white blood cell count (WBC) and to examine the mechanisms involved. ⋯ Glucocorticoid inhalation increases WBC by increasing ANC. Reduced neutrophil adhesion to the endothelial surface, mediated by decreased adhesion molecule expression on neutrophils, is a plausible mechanism. Physicians should be aware of the effect of inhaled corticosteroids on WBC, as it may influence clinical decisions, especially in the emergency department.
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Randomized Controlled Trial
Single rescuer ventilation using a bag-valve mask with internal handle: a randomized crossover trial.
To compare tidal volume received during single rescuer ventilation with a modified bag-valve mask (BVM) with integrated internal handle vs standard BVM among healthy volunteers using a manikin model. ⋯ The modified BVM with integrated internal handle results in greater mean received tidal volume compared with standard BVM during single rescuer ventilation in a manikin model. This modified BVM design may prove a useful airway adjunct for ventilation.
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Randomized Controlled Trial Comparative Study
Using the skin protective lotion IB1 as a substitute for chemical protective gloves.
We aimed to evaluate the performance of medical personnel in using the IB1 topical protective lotion on their hands and wrists together with standard disposable medical gloves, compared to standard-issued medical chemical protective gloves. This randomized cross-over study included 144 medical personnel. Primary endpoints were time-to-completion of autoinjection; success rate, number of attempts, and time-to-achieve successful endotracheal intubation; time-to-achieve satisfactory tube fixation; time-to-draw and inject the content of an ampoule; and the total time-to-perform all medical procedures. ⋯ For all medical procedures, the use of IB1 was reported as significantly more convenient than the use of chemical protective gloves (P<.001 for all comparisons). IB1 with standard medical gloves significantly shorten the time-to-perform medical procedures requiring fine motor dexterities and is subjectively more convenient than chemical protective gloves. IB1 should be considered as an appropriate alternative for medical teams in a chemical event.
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Randomized Controlled Trial
A randomized controlled trial assessing the use of ultrasound for nurse-performed intravenous placement in difficult access patients in the ED.
This study analyzed outcomes associated with nurse-performed ultrasound (US)-guided intravenous (IV) placement compared to standard of care (SOC) palpation IV technique on poor vascular access patients. ⋯ In difficult access patients, nurses were more successful in obtaining IV access using US guidance than palpation SOC technique. Lengthier placement times were observed more frequently when the SOC IV technique was used.
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Randomized Controlled Trial
Effects of spinal immobilization at 20° on respiratory functions.
The purpose of the study is to investigate whether spinal immobilization with a long backboard (LBB) and semirigid cervical collar (CC) at 20° instead of 0° conserve pulmonary functions, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. ⋯ The results of this and previous studies have shown that traditional spinal immobilization decreases respiratory function, whereas using spinal immobilization at 20° can reduce this decrease in function.