The American journal of emergency medicine
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Comparative Study Observational Study
Using Canadian CT head rule in a developing nation: Validation and comparing utilisation by emergency physicians and neurosurgeons.
The objective of this study was to test the validity of the Canadian CT Head rule (CCHR) in cases of minor traumatic brain injury (TBI) in an Indian emergency department (ED). A secondary objective was to compare of the patterns of neuroradiology references between the emergency physician (EP) and the neurosurgeon. ⋯ The CCHR has 100% sensitivity as a screening tool for patients requiring CT brains in case of TBI though the specificity is found to be rather low (45.8%). EPs show a higher level of awareness and inclination to use CDRs in cases of minor TBI to direct the decision for neuro-radiology, in comparison to neurosurgeons. ED residents reported comfort in mobile application based usage of the rule.
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To determine whether the combination of skin tapes and tissue adhesive is superior to either method alone for laceration repair. ⋯ This study demonstrates that the combination of skin tapes and tissue adhesive provides superior immediate wound closure strength to either of these methods alone in a porcine model.
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Observational Study
Association between wide QRS pulseless electrical activity and hyperkalemia in cardiac arrest patients.
We evaluated the relationship between hyperkalemia and wide QRS complex in patients with pulseless electrical activity (PEA) cardiac arrest. ⋯ Wide QRS PEA as an initial cardiac rhythm was significantly associated with hyperkalemia in cardiac arrest patients.
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Detection of a pulse is crucial to decision-making in the care of patients who are in cardiac arrest, however, the current standard of manual pulse palpation is unreliable. An emerging alternative is the use of point-of-care ultrasound (POCUS) for direct assessment of the carotid pulse. The primary objective of this study is to determine the interobserver reliability for physician interpretation of pre-recorded point-of-care ultrasound pulse-check clips for patients who are in cardiac arrest. ⋯ Interpretation of the carotid pulse by POCUS showed high interobserver reliability. Further work must be done to determine the performance of POCUS pulse assessment in real-time for patients who are in cardiac arrest.