The American journal of emergency medicine
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Review Meta Analysis
Airway management in out-of-hospital cardiac arrest: A systematic review and network meta-analysis.
Airway management during cardiopulmonary resuscitation is particularly important for patients with out-of-hospital cardiac arrest (OHCA). This study was performed to compare the efficacy of the most commonly used out-of-hospital airway management methods in increasing the survival to discharge in patients with OHCA. ⋯ As the gold standard of airway management for patients with out-of-hospital cardiac arrest in most countries, endotracheal intubation (ETI) has been widely used for many years. However, our systematic review and network meta-analysis showed that ETI is no better than other methods in increasing the survival to discharge. This is not directly proportional to the various preparations required before ETI. Additional randomized controlled trials are needed to identify more effective methods and improve patients' outcome.
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Review Case Reports
Adnexal torsion in pregnancy: A systematic review of case reports and case series.
This study aimed to investigate clinical presentations, surgical procedures and findings, complications, and predisposing factors of adnexal torsion in pregnant women. ⋯ Clinicians should think of adnexal torsion when pregnant women complain of sudden-onset pain. Then, using ultrasound, adnexal enlargement or masses should be explored seriously. They should take invasive and urgent therapy to preserve ovaries and prevent complications.
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Multicenter Study
Development of a prehospital lactic acidosis score for early-mortality. A prospective, multicenter, ambulance-based, cohort study.
Lactic acidosis is a clinical status related to clinical worsening. Actually, higher levels of lactate is a well-established trigger of emergency situations. The aim of this work is to build-up a prehospital early warning score to predict 2-day mortality and intensive care unit (ICU) admission, constructed with other components of the lactic acidosis besides the lactate. ⋯ Our results showed that PLA predicts 2-day mortality better than other lactic acidosis components alone. Including PLA score in prehospital setting could improve emergency services decision-making.
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Acute bacterial meningitis in adults is a rare but serious condition that carries a high rate of morbidity. ⋯ A better understanding of the pearls and pitfalls of acute bacterial meningitis can assist emergency clinicians in pursuing its timely diagnosis and management.
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Review
Ultrasound for the diagnosis of necrotizing fasciitis: A systematic review of the literature.
Necrotizing fasciitis (NF) is a deadly disorder that can be challenging to diagnose on history and examination alone. Point-of-care ultrasound (POCUS) is widely available and has been increasingly used for diagnosing skin and soft tissue infections. We performed a systematic review to determine the accuracy of POCUS for diagnosing NF with subgroup analyses of the accuracy of specific POCUS examination components. ⋯ POCUS has good sensitivity and specificity for the diagnosis of NF. POCUS should be considered as an adjunct to the initial clinical decision making for the diagnosis of NF.