The American journal of emergency medicine
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To identify tools that predict the risk of complications in patients presenting to outpatient clinics or emergency departments (ED) with acute infectious diarrhea. ⋯ As a risk-stratification tool, the CDS has been validated only for children. Further research is needed to develop and validate a tool suitable for adults in the ED.
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The cardiopulmonary resuscitation (CPR) compression to ventilation strategy remains controversial. We conducted a meta-analysis to compare the outcomes between continuous chest compressions CPR with asynchronous ventilation (CCC-CPR) and interrupted chest compressions CPR with synchronous ventilation (ICC-CPR) in cardiac arrest. ⋯ CCC-CPR did not show superiority in human outcomes compared with ICC-CPR, but its effect value was significantly increased in animal experiments. We should take the positive outcomes from animals and apply them to human models, and more physiological mechanisms need to be confirmed in CPR patients with different compression-ventilation strategies to improve the prognosis of cardiac arrest.
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The iodinated contrast material (ICM) shortage of 2022 has affected healthcare systems worldwide, forcing institutions to adapt by implementing interventions to conserve ICM without compromising patient care. We aim to present the practices proven to be effective in reducing ICM consumption to improve resource allocation in trauma patients. ⋯ In response to the ICM shortage of 2022, most healthcare institutions have found the use of alternative imaging modalities to be effective in reducing ICM consumption. Other effective measures include ICM dose reduction and ICM waste minimization.
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Therapeutic hypothermia was recommended as the only neuroprotective treatment in comatose patients after return of spontaneous circulation (ROSC). With new evidence suggesting a similar neuroprotective effect of 36 °C and 33 °C, the term "therapeutic hypothermia" was substituted by "targeted temperature management" in 2011, which in turn was replaced by the term "temperature control" in 2022 because of new evidence of the similar effects of target normothermia and 33 °C. However, there is no clear consensus on the efficacy of therapeutic hypothermia. In this article, we provide an overview of the recent evidence from basic and clinical research related to therapeutic hypothermia and re-evaluate its application as a post-ROSC neuroprotective intervention in clinical settings.
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Spurred by the Coronavirus infectious disease 2019 pandemic, aerosol containment devices (ACDs) were developed to capture infectious respiratory aerosols generated by patients at their source. Prior reviews indicated that such devices had low evidence of effectiveness, but did not address how ACDs should be evaluated, how well they should perform, nor have clearly defined performance standards. Towards developing design criteria for ACDs, two questions were posed: 1) What characteristics have guided the design of ACDs? 2) How have these characteristics been evaluated? ⋯ With respect to aerosol containment, ACDs should reduce exposure among HCP with the device compared with the absence of the device, and provide ≥90% reduction in respirable aerosols, equivalent in performance to N95 filtering facepiece respirators, if the goal is to reduce reliance on personal protective equipment. The ACD should not increase awkward or uncomfortable postures, or adversely impact biomechanics of the procedure itself as this could have implications for procedure outcomes. A variety of standardized instruments exist to assess the experience of patients and healthcare personnel. Integration of ACDs into routine clinical practice requires rigorous studies of aerosol containment and the user experience.