The American journal of emergency medicine
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Comparative Study
The interrater variation of ED abdominal examination findings in patients with acute abdominal pain.
The physical examination of the abdomen is crucial to emergency department (ED) management of patients with abdominal pain. We sought to determine the interrater variation between attending and resident physicians in detecting abdominal exam findings. ⋯ There was moderate agreement between resident and attending physicians for most of the findings in patients with abdominal pain. Recognition that selected findings are more variable than others should encourage careful confirmation of resident physicians' assessments in teaching settings.
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Comparative Study
Biphasic extrathoracic cuirass ventilation for resuscitation.
The MRTX portable lightweight respirator (MRTX) provides noninvasive respiratory support using biphasic extrathoracic ventilation via a cuirass fitted around the patient's chest. ⋯ Biphasic cuirass ventilation is an easily learned and rapidly applied method suitable for use by nonmedical personnel, even when wearing cumbersome protective gear.
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Comparative Study Clinical Trial
Comparing 2 methods of emergent zipper release.
There are several types of emergent zipper release methods described. The standard method can be difficult. The purpose of this study is to determine if an alternate method of zipper release can be easier to accomplish. ⋯ The alternate method of zipper release is faster and easier than the standard method of zipper release; however, the optimal procedure is also dependent on the location of the entrapped tissue relative to the zipper actuator and the type of zipper.
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To estimate the sensitivity of room-air pulse oximetry in the detection of moderate hypercapnia. ⋯ Room-air pulse oximetry detects moderate hypercapnia with high sensitivity.
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Comparative Study
Real-time paramedic compared with blinded physician identification of ST-segment elevation myocardial infarction: results of an observational study.
The aim of the study were to determine if paramedics can accurately identify ST-segment elevation myocardial infarction (STEMI) on prehospital 12-lead (PHTL) electrocardiogram and to compare paramedic with blinded physician identification of STEMI. Paramedics identified definite STEMI, or possible acute myocardial infarction but not definite, and nondiagnostic. Two blinded readers (cardiologist and emergency physician) independently categorized each PHTL. ⋯ Paramedic sensitivity was 0.80 (95% CI, 0.64-0.96); specificity was 0.97 (95% CI, 0.94-1.00) with positive likelihood ratio of 25.2 and negative likelihood ratio of 0.21. Overall accuracy was similar for paramedic and physician reviewers (0.94, 0.93, 0.95). Highly trained paramedics in an urban emergency medical services system can identify patients with STEMI as accurately as blinded physician reviewers.