The American journal of emergency medicine
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Pulmonary hypertension (PH) is characterized by increased pulmonary vascular resistance and pulmonary arterial pressure and is associated with significant morbidity and mortality. ⋯ An understanding of the pathophysiology of PH and available emergency treatments can assist emergency clinicians in reducing the immediate morbidity and mortality associated with this disease. Restarting maintenance PH medications and proper selection of vasopressors and inotropes will benefit decompensating patients with PH.
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Double sequential defibrillation (DSD) has been proposed as a viable treatment option for patients in refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) out-of-hospital cardiac arrests (OHCA). However, currently there is insufficient evidence to support a widespread implementation of this therapy. ⋯ To date, it is difficult to conclude the real benefit of DSD for patients in refractory VF based on the available evidence. The findings of this scoping review suggest there is limited evidence to support at large-scale the use of DSD for refractory VF/pVT OHCA. Further research is needed to better characterize and understand the use of DSD for refractory VF/pVT, in order to implement best practices to maximize the effectiveness and efficiency of care.
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Double sequential defibrillation (DSD) has been proposed as a viable treatment option for patients in refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) out-of-hospital cardiac arrests (OHCA). However, currently there is insufficient evidence to support a widespread implementation of this therapy. ⋯ To date, it is difficult to conclude the real benefit of DSD for patients in refractory VF based on the available evidence. The findings of this scoping review suggest there is limited evidence to support at large-scale the use of DSD for refractory VF/pVT OHCA. Further research is needed to better characterize and understand the use of DSD for refractory VF/pVT, in order to implement best practices to maximize the effectiveness and efficiency of care.
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Review Meta Analysis
Video capsule endoscopy for upper gastrointestinal hemorrhage in the emergency department: A systematic review and meta-analysis.
The assessment of the severity of upper gastrointestinal hemorrhage in emergency department (ED) patients is difficult to assess with commonly available diagnostic tools. Small studies have shown that video capsule endoscopy (VCE) is a promising risk-stratification method and may be better than current clinical decision rules such as the Rockall score and the Glasgow Blatchford score. This review aims to assess the accuracy of VCE to detect active upper gastrointestinal hemorrhage compared to a reference standard. ⋯ VCE demonstrated high accuracy for detecting upper GI hemorrhage in this meta-analysis of existing studies. In light of the potential advantages of VCE in the ED, further research is warranted to further establish its role.
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Review Meta Analysis
Video capsule endoscopy for upper gastrointestinal hemorrhage in the emergency department: A systematic review and meta-analysis.
The assessment of the severity of upper gastrointestinal hemorrhage in emergency department (ED) patients is difficult to assess with commonly available diagnostic tools. Small studies have shown that video capsule endoscopy (VCE) is a promising risk-stratification method and may be better than current clinical decision rules such as the Rockall score and the Glasgow Blatchford score. This review aims to assess the accuracy of VCE to detect active upper gastrointestinal hemorrhage compared to a reference standard. ⋯ VCE demonstrated high accuracy for detecting upper GI hemorrhage in this meta-analysis of existing studies. In light of the potential advantages of VCE in the ED, further research is warranted to further establish its role.