The American journal of emergency medicine
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Randomized Controlled Trial Comparative Study
Comparison of Xenon with LED illuminant in difficult and inhalation injury airway scenario: A randomized crossover manikin study.
The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. ⋯ The LED laryngoscope light handle did not affect the recorded intubation times in the simulated difficult airway scenario, but provided significant advantages in the inhalation injury airway scenario that combines a difficult airway with a limited view caused by a sooted pharynx. We therefore hypothesize, that the LED illuminant might be beneficial in the airway management of burn patients with severe inhalation injury.
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Randomized Controlled Trial Comparative Study
Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial.
The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). ⋯ This study suggests that modified VM therapy was more effective than standard VM for terminating PSVT. The modified VM therapy also indirectly reduced the need for anti-arrhythmic medication and indirectly caused fewer side effects.
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Extracorporeal cardiopulmonary resuscitation (ECPR) followed by operating room sternotomy, rather than resuscitative thoracotomy, might be life-saving for patients with blunt cardiac rupture and cardiac arrest who do not have multiple severe traumatic injuries. A 49-year-old man was injured in a vehicle crash and transferred to the emergency department. On admission, he was hemodynamically stable, but a plain chest radiograph revealed a widened mediastinum, and echocardiography revealed hemopericardium. ⋯ In this patient, ECPR rapidly restored brain perfusion and provided enough time to perform operating room sternotomy, allowing for good surgical exposure of the heart. Moreover, open cardiac massage was unnecessary. ECPR with sternotomy and cardiac repair is advisable for patients with blunt cardiac rupture and cardiac arrest who do not have severe multiple traumatic injuries.
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Randomized Controlled Trial
The effect of trimetazidine treatment in patients with type 2 diabetes undergoing percutaneous coronary intervention for acute myocardial infarction.
Trimetazidine (TMZ) improves clinical outcomes in patients with chronic heart failure and stable coronary artery disease. No study has yet evaluated the efficacy of TMZ in type 2 diabetes patients with acute myocardial infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI). We performed this study to evaluate the efficacy TMZ in DM patients with AMI undergoing PCI, such as the effect on reductions in myocardial enzyme, improvements in liver function, modulation of glucose levels, and improvement in cardiac function. ⋯ Among type 2 diabetic patients with AMI undergoing PCI, TMZ significantly reduces serum myocardial enzyme, improves liver function, adjusts blood glucose and improves cardiac function.
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Comparative Study
Comparison of qSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.
The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis. ⋯ Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes.