The American journal of emergency medicine
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Randomized Controlled Trial
Performance comparison of intraosseous devices and setups for infusion of whole blood in a cadaveric swine bone model.
Intraosseous (IO) access can provide a critical bridge for blood product infusion when peripheral venous access is not obtainable. Successful pressurized IO infusion requires flow rates sufficient to preserve life, but with infusion pressures low enough to avoid clinical complications (e.g., hemolysis, bone damage, fat emboli). However, the optimal method for pressured IO delivery of blood was unknown. ⋯ Some pressured IO infusion methods can achieve flow rates adequate to serve as a resuscitative bridge in the massively hemorrhaged trauma victim, but flow rates and pressures vary greatly across IO pressurized infusion methods. Manual Rapid Infuser and push-pull methods conferred high flow rates but also relatively high pressures, highlighting the importance of using in vivo models in future research to assess the possible clinical complications of using these promising methods. Combined, present findings highlight the importance of studying pressurized IO methods towards preserving the life of the critically injured trauma victim.
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Randomized Controlled Trial
Sub dissociative dose of ketamine with haloperidol versus fentanyl on pain reduction in patients with acute pain in the emergency department; a randomized clinical trial.
Ketamine is known to be an effective factor in reducing pain without significant side effects. ⋯ Ketamine works better than fentanyl in controlling acute pain, and limited side effect of agitation can be controlled if injected with haloperidol. Due to its better function and fewer side effects, it seems that in controlling acute pain, Ketamine along with Haloperidol can be a good alternative to opioids.
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Randomized Controlled Trial
Retromolar intubation with video intubating stylet in difficult airway: A randomized crossover manikin study.
Difficult airway situations, such as trismus and neck rigidity, may prohibit standard midline orotracheal intubation. An alternative route of intubation from the retromolar space using a fiberoptic scope or rigid intubation stylet has been reported. There is no study investigating the applicability of retromolar intubation using a video intubating stylet. This study comparatively analyzed difficult airway management using a video intubating stylet in the retromolar and standard midline approaches. ⋯ The retromolar approach for intubation using a video intubating stylet may be a promising choice for selected patients with a combination of difficult airway features such as limited mouth opening, neck rigidity, and edematous tongue.
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Randomized Controlled Trial
Effects of resuscitation guideline terminology on pediatric cardiopulmonary resuscitation.
This study aimed to investigate the effect of resuscitation guideline terminology on pediatric cardiopulmonary resuscitation (CPR) performance. ⋯ Average CCD during simulated pediatric CPR according to the CCD target of '5 cm' was significantly lower than those according to the CCD target of 'at least one third of the anterior-posterior dimension of the chest'.