The American journal of emergency medicine
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Comparative Study
Use of a radial artery compression device for noninvasive, near-continuous blood pressure monitoring in the ED.
This study's goal was to test a novel device using continuous partial radial artery compression for mean arterial pressure (MAP) measurement. A prospective, nonblind, convenience-sample trial at a level I center (annual ED census 70,000) enrolled 15 adults with indwelling radial arterial catheters and accessible contralateral radial pulse. Subjects had MAPs measured simultaneously by test device (TEST assessments), oscillometric brachial artery cuff (OSC), and arterial line (ART). ⋯ R(2) values for ART/OSC and ART/TEST were 0.96 and 0.95, respectively (P <.001). TEST and OSC MAP readings were equally likely (P = 0.66) to be within 5 mm Hg of ART in both the overall set of 307 MAPs and in the subset of 120 cases in which ART MAPs were below 80 (P = .47). The TEST device performed at least as well as oscillometric assessment, offering advantages of noninvasive, near-continuous data.
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Comparative Study
Comparison of sexual assaults by strangers versus known assailants in a community-based population.
The medical literature has generally supported the view that sexual assaults by strangers are more serious and more violent than assaults by people known to the victims. This retrospective study was conducted to compare characteristics of sexual assaults by strangers and those by people known to the victims in a community-based population of women. Study patients were consecutive female patients, age 13 years or older, presenting to a sexual assault clinic during a 40-month study period. ⋯ Sexual assault by a stranger was more likely to occur in the home of the victim (43% v 28%, P < .001), involve weapons or physical coercion (58% v 31%, P < .001), and was associated with more non-genital injuries (61% v 40%, P < .001). However, the overall frequency of anogenital trauma (77% v 71%, P = .10), the mean number of anogenital injuries (2.0 v 2.3, P = .05), and the types of genital trauma were similar in both groups of women. These results demonstrated that 71% of the victims of acquaintance rape sustain anogenital trauma and that these injuries may be as extensive as those caused by unknown assailants.
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A difficult to intubate patient occurs infrequently in the emergency department. The endotracheal tube introducer or gum elastic bougie is a device used by British anesthesiologists in difficult airways. The device is inexpensive, has few complications and is easy to use. Similar to the Seldinger technique for gaining access to a large central vein, the endotracheal tube introducer is used to assist in cannulating the trachea and acts like the wire in central vein access.