Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
A Comparison of the Effect of Interposed Abdominal Compression-Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation Methods on End Tidal CO2 and the Return of Spontaneous Circulation following Cardiac Arrest: A Clinical Trial.
Sudden cardiac arrest is a major cause of death in the adult population of developed countries, with only 10%-15% of cardiopulmonary resuscitations (CPRs) being successful. We aimed to compare the effects of interposed abdominal compression CPR (IAC-CPR) with standard CPR (STD-CPR) methods on end-tidal CO2 (ETCO2 ) and the return of spontaneous circulation (ROSC) following cardiac arrest in a hospital setting. ⋯ The increase in the ETCO2 during IAC-CPR is an indicator of the increase in cardiac output following the use of this method of CPR.
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Utilization of emergency departments (EDs) for pediatric mental health (MH) complaints is increasing. These patients require more resources and have higher admission rates than those with nonpsychiatric complaints. ⋯ Use of quality improvement methodology led to a redesign that was associated with a significant reduction in mean LOS of patients with psychiatric complaints and improved ED staff perception of care.
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Randomized Controlled Trial
Safety of a 4-Factor Prothrombin Complex Concentrate versus Plasma for Vitamin K Antagonist Reversal: an Integrated Analysis of two Phase IIIb Clinical Trials.
Clinicians often need to rapidly reverse vitamin K antagonists (VKAs) in the setting of major hemorrhage or urgent need for surgery. Little is known about the safety profile of the traditional reversal agent, plasma, or the newly approved agent, four-factor prothrombin complex concentrate (4F-PCC), in a randomized setting. This is an integrated analysis of safety data from two clinical trials that evaluated 4F-PCC versus plasma for the treatment of patients requiring rapid VKA reversal for acute major bleeding or prior to an urgent surgical/invasive procedure. ⋯ These safety data represent the largest controlled assessment of a 4F-PCC to date. For patients requiring urgent VKA reversal, 4F-PCC had a safety profile similar to that of plasma (AEs, SAEs, thromboembolic events, and deaths), but was associated with fewer fluid overload events.