Resuscitation
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Randomized Controlled Trial
The quality of cardiopulmonary resuscitation using supraglottic airways and intraosseous devices: a simulation trial.
To assess whether using interventions such as laryngeal mask airways (LMA) and IO lines lead to improved resuscitation in a simulated cardiac arrest when compared to standard methods of endotracheal intubation (ETI) and central line placement. ⋯ Use of an LMA and an IO device led to significantly faster establishment of an airway and vascular access in a simulated cardiac arrest. The variation in devices did not affect time to defibrillation or percent hands off time.
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The best performing early warning score is Vitalpac™ Early Warning Score (ViEWS). However, it is not known how often, to what extent and over what time frame any early warning scores change, and what the implications of these changes are. ⋯ After a median interval of 30 h both the initial abbreviated ViEWS recording and subsequent changes in it both predict clinical outcome. It remains to be determined what interventions during this time frame will improve patient outcomes.
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Randomized Controlled Trial Comparative Study
Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine--a randomized, controlled simulation study.
Emergency medical services (EMSs) vary considerably. While some are physician staffed, most systems are run by paramedics. The objective of this randomized, controlled simulation study was to compare the emergency care between physician staffed EMS teams (control group) and paramedic teams that were supported telemedically by an EMS physician (telemedicine group). ⋯ Telemedically assisted paramedic care was feasible and at least not inferior compared to standard EMS teams with a physician on-scene in these scenarios.
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N-acetylcysteine (NAC) has been investigated to attenuate organ injury in various experimental and clinical studies. However, results in hemorrhagic shock (HS) were controversial. We determined the effects of continuous administration of NAC on acute lung injury (ALI) and acute kidney injury (AKI) in HS model. ⋯ Continuous infusion of NAC attenuated inflammatory response and acute lung and kidney injury after hemorrhagic shock in rats.