European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The De Winter ECG pattern has been reported to indicate acute left anterior descending coronary artery occlusion and is often considered to be an 'ST elevation myocardial infarction (STEMI) equivalent'. We aimed to investigate the morphology of the 'De Winter ECG pattern' and evaluate the test characteristics of the De Winter pattern for the diagnosis of acute coronary occlusion. We identified papers through the Medline, EMBASE and COCHRANE databases and screened for bias using QUADAS-2. ⋯ There is limited evidence that the De Winter ECG pattern is a 'STEMI equivalent'. The available data suggest that the pattern has high positive predictive value for acute occlusion. Further research is required to evaluate specificity and to determine whether rapid revascularization improves mortality.
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Randomized Controlled Trial
Out-of-hospital cardiopulmonary resuscitation strategies using one-handed chest compression technique for children suffering a cardiac arrest.
We evaluated the decrease in chest compression depth during 30 : 2 compression-to-ventilation ratio one-handed chest compression (OHCC) in an out-of-hospital pediatric arrest setting, and whether switching hands every other cycle could maintain compression depth. ⋯ Compression depth decreased significantly after 4 min during 30 : 2 ratio OHCC. However, it was maintained by changing from the OHCC to the two-handed chest compression or by alternating compression hands every other cycle.
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Randomized Controlled Trial
Chest compression using the foot or hand method: a prospective, randomized, controlled manikin study with school children.
Maintaining a chest compression depth of 5 cm or more as specified by resuscitation guidelines is difficult. Historical studies have shown an advantage of the foot method (FM) over the hand method (HM) in participants weighing less than 50 kg. Because of the fact that the importance of chest compression is increasing from guideline to guideline, the FM technique had not been evaluated conclusively and worldwide resuscitation is taught to school children, we investigated whether school children achieved a higher quality of chest compression with the FM than with the HM. ⋯ The FM of applying chest compression did not result in a more accurately delivered compression depth compared with the HM for children and adolescents, irrespective of body weight.
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We investigated whether there are differences in emergency department (ED) patient management associated with emergency physician (EP) sex, specifically in terms of ordering investigations and hospital admissions. ⋯ Female EPs order more investigations and admit more patients, although from our results the reason for this is unclear, and the impact on healthcare effectiveness and patient outcome is unknown.