The American journal of emergency medicine
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Review Meta Analysis
Recombinant human soluble thrombomodulin and short-term mortality of infection patients with disseminated intravascular coagulation: a meta-analysis.
Several studies have demonstrated that recombinant human soluble thrombomodulin (rhTM) has potential advantages for the treatment for patients with infection complicated by disseminated intravascular coagulation (DIC). However, whether injection of rhTM can affect the mortality of those patients in clinical treatment remains controversial. Therefore, we conducted a meta-analysis to evaluate the clinical efficacy for patients with infection complicated by DIC. ⋯ Based on the current studies, using rhTM for the treatment for infection patients complicated with DIC does not decrease the short-term mortality of those patients. More high-quality RCT studies need to be performed to confirm this finding.
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Observational Study
Amino-terminal pro-B-type natriuretic peptide, inferior vena cava ultrasound, and biolectrical impedance analysis for the diagnosis of acute decompensated heart failure.
Both Framingham criteria and natriuretic peptides (NPs) may worsen their diagnostic validity for acute decompensated heart failure (ADHF) in elderly patients with comorbidities, mainly renal failure. Ultrasound of inferior vena cava (IVCu) and bioelectrical impedance analysis (BIA) are useful tools for detecting ADHF, although their utility compared with NP is not fully established. ⋯ Inferior vena cava ultrasonography and BIA analysis are as useful as NT-proBNP to ADHF diagnosis, validated in an elderly population with kidney disease.
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Randomized Controlled Trial
Impact of a feedback device on chest compression quality during extended manikin cardiopulmonary resuscitation: a randomized crossover study.
Chest compressions require physical effort leading to increased fatigue and rapid degradation in the quality of cardiopulmonary resuscitation overtime. Despite harmful effect of interrupting chest compressions, current guidelines recommend that rescuers switch every 2 minutes. The impact on the quality of chest compressions during extended cardiopulmonary resuscitation has yet to be assessed. ⋯ A real-time feedback device delivers longer effective, steadier chest compressions over time. An extrapolation of these results from simulation may allow rescuer switches to be carried out beyond the currently recommended 2 minutes when a feedback device is used.
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Accidental drowning can cause out-of-hospital cardiac arrest (OHCA). We investigated the effect of drowning location on outcomes of individuals who experienced drowning-OHCA. ⋯ Individuals who experience drowning-OHCA in public locations with safety regulations had a better rate of survival. There should be improved public awareness of the significantly greater risk of drowning-OHCA in locations that have no safety regulations.
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Multicenter Study
Accuracy of the history of injury obtained from the caregiver in infantile head trauma.
We investigated the accuracy of parental reports of infant trauma history. ⋯ The accuracy of the history obtained from the caregivers of infants may be low in severe infantile head trauma. Therefore, medical professionals should treat the mechanism of injury obtained from caregivers as secondary information and investigate for possible AHT in cases with inconsistencies between the history that was taken and the severity of the injury observed.