The American journal of emergency medicine
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Randomized Controlled Trial
Utilization of a gum elastic bougie to facilitate single lung intubation.
Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated. Therefore, single lung intubation may be significantly delayed in these patients. The purpose of this study was to assess the accuracy of using a gum elastic bougie ("bougie") to facilitate single lung intubation. ⋯ In our cadaveric model of mainstem intubation, bougie-guided single lung intubation was highly accurate for both left and right mainstem intubations. Future studies should assess the accuracy of this technique among different providers and bodies, as well as live patients.
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This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. ⋯ The use and implementation of SOPs and checklists in prehospital emergency medicine have shown some benefits of improving guidelines adherence and patient outcomes in airway management, patient records, identification and triage, and other prehospital interventions. More research in this area is necessary to optimize the future use and implementation of SOPs and checklists to improve emergency personnel performance and patient outcomes.
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Randomized Controlled Trial
Effect of bed width on the quality of compressions in simulated resuscitation: a randomized crossover manikin study.
To investigate the effects of bed width on the quality of chest compressions during simulated in-hospital resuscitation. ⋯ When rescuers performed chest compressions on an emergency stretcher, chest compression quality increased, and the fatigue of rescuers decreased compared with a standard hospital bed. Therefore, we propose a narrow bed for critically ill inpatients with high risk of cardiac arrest.
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Randomized Controlled Trial
Is retrograde intubation more successful than direct laryngoscopic technique in difficult endotracheal intubation?
Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. ⋯ The RI technique had a higher success rate in difficult airway intubation than the DL technique, regardless of experience.
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Observational Study
Usefulness of the thrombolysis in myocardial infarction risk index in acute heart failure: a pilot study.
Risk stratification in acute heart failure (AHF) is vital for both physicians and paramedical personals. Thrombolysis in myocardial infarction (TIMI) risk index (TRI) and modified TRI (mTRI) are novel and simple predictive risk indices that have been examined in patients with acute coronary syndrome. ⋯ The TRI is a simple and strong predictor of all-cause mortality in patients who were admitted with AHF. The current study reveals for the first time the strong predictive value of TRI in patients with AHF.