The American journal of emergency medicine
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Letter Case Reports
Repeated administrations of crotalid Fab antivenin in the same patient.
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Randomized Controlled Trial Clinical Trial
Tap water for irrigation of lacerations.
This study was designed to compare the infection rates of simple lacerations irrigated with tap water versus sterile normal saline before repair. Patients with simple lacerations to an extremity that were less than 8 hours from injury were prospectively enrolled. Exclusions from the study were: dog bites, hand lacerations, immunocompromised patients, and those on antibiotics at the time of injury. ⋯ Wound infection rates were the same in both groups. This pilot study suggests that the use of tap water for irrigation of wounds may be safe. Further validation is necessary.
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Comparative Study
Effect of intra-aortic occlusion balloon in external thoracic compressions during CPR in pigs.
This study was performed to compare the effectiveness of external thoracic compressions with and without intra-aortic occlusion balloon with capnography and coronary and cerebral perfusion pressure (CPP) in the normothermic and traumatic-less cardiopulmonary arrest provoked by a ventricular fibrillation in pigs. This was an experimental study (cross-over study) in 14 pigs with similar characteristics (23 +/- 2 kg, 10-12 weeks of age). After an 8-minute nonintervention period, the cardiopulmonary resuscitation (CPR) consists of 4 periods of 5 minutes alternating CPR with and without intra-aortic occlusion balloon. ⋯ These increases are less important in the final periods. Intra-aortic balloon occlusion increased ETCO(2), coronary, and cerebral perfusion pressures. An early application of this technique was important.
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The study objective was to prospectively evaluate the frequency and severity of behavioral reactions occurring in children receiving ketamine sedation in the emergency department (ED). A behavioral observational study was conducted. Ketamine was given in a standardized protocol with midazolam, atropine, and a prehypnotic suggestion. ⋯ Mild reactions described as not unpleasant occurred in 7/205 (3.4%, 95% CI 0.9-5.9%) of the younger age group, and 2/96 (2.1%, 95% CI 0-5.0%) of the older age group. Unpleasant reactions occurred in 2/205 (1.0%, 95% CI 0-2.4%) of the younger age group, and 4/96 (4.2%, 95% CI 0-8.2%) of the older age group. We observed no clinically important difference in the proportion of older versus younger children experiencing behavioral reactions after IV ketamine sedation.