The American journal of emergency medicine
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Multicenter Study
Intubations in elderly patients have decreased from 1999 through 2014-Results of a multi-center cohort study.
Advances in pharmacologic therapy, non-invasive positive pressure ventilation (NIPPV) and advanced directives may have decreased the intubations of dyspneic elderly (≥65years old) patients in the emergency department (ED). ⋯ Intubation rates for patients≥65 decreased from 1999 through 2014, particularly in CHF patients. We speculate that these findings reflect wider implementation of NIPPV, other therapeutic modalities and advanced directives.
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Randomized Controlled Trial Multicenter Study
The effect of fibrinogen concentrate and fresh frozen plasma on the outcome of patients with acute traumatic coagulopathy: A quasi-experimental study.
The debate on replacing coagulation factors and its effect on the final outcome of the patients with acute traumatic coagulopathy (ATC) in need of transfusion is still ongoing. Therefore, the present study is designed with the aim of comparing the outcome of patients with acute traumatic coagulopathies receiving fibrinogen and fresh frozen plasma (FFP). ⋯ Multiple trauma patients in need of transfusion who received fibrinogen along with packed cells had significantly better outcomes regarding mortality, sepsis, need for admission to the intensive care unit, need for receiving packed cells, need for receiving intravenous fluids in the initial 24h, and duration of hospitalization.
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Multicenter Study
Association of fentanyl use in rapid sequence intubation with post-intubation hypotension.
The anesthesia literature has reported that pre-intubation fentanyl use is associated with post-intubation hypotension which is a risk factor of poor post-emergency department (ED) prognosis. However, little is known about the relations between fentanyl use for intubation and post-intubation hypotension in the ED. We aimed to determine whether pretreatment with fentanyl was associated with a higher risk of post-intubation hypotension in the ED. ⋯ In this prospective multicenter study of ED airway management, pretreatment with fentanyl in rapid sequence intubation was associated with higher risks of post-intubation hypotension.