European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
Teaching basic life support: a prospective randomized study on low-cost training strategies in secondary schools.
Cardiopulmonary resuscitation (CPR) training at school is recommended. Limited school resources prevent implementation. The learning efficacy of low-cost training strategies is unknown. ⋯ Training efficacy with low-cost equipment was not different from training with a manikin. The outcome for all training strategies was suboptimal. The basics of CPR can be taught with alternative equipment if manikins are not available.
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Randomized Controlled Trial
Use of predefined biochemical admission profiles does not reduce the number of tests or total cost: a randomized-controlled pilot study.
The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost. ⋯ The use of a predefined blood test panel did not significantly affect the number of tests, total cost, or length of stay for acutely admitted medical patients compared with tests ordered at the discretion of the treating physician.
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Randomized Controlled Trial Comparative Study
Reducing the potential for tourniquet-associated reperfusion injury.
Investigate a strategy to minimize tourniquet-associated reperfusion injury. ⋯ A staggered tourniquet release was associated with greater haemodynamic stability and reduced the rate of acute systemic metabolic changes associated with limb reperfusion. Reapplication of a tourniquet seemed to halt further reperfusion, providing a window period for patient evaluation and management.
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Randomized Controlled Trial
A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors.
A small group of frequent visitors to emergency departments accounts for a disproportional large number of total emergency department visits. Previous interventions in this population have shown mixed results. ⋯ Our results indicate that the nurse-managed telephone-based case-management intervention represents a possible strategy to improve care for frequent emergency department users as well as decrease outpatient visits, admission days and healthcare costs.
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Randomized Controlled Trial
Evaluation of advanced airway management in absolutely inexperienced hands: a randomized manikin trial.
Endotracheal intubation (ETI) and basic ventilation techniques (i.e. mouth-to-mouth/nose, bag-valve-mask ventilation) require skills and training. As an alternative, supraglottic airway devices (SAD) are efficient and technically easy to insert. We therefore evaluated the time to ventilation, success rate, and skill retention for various airway management approaches by medical laypersons using a manikin model. ⋯ A variety of SAD all proved to reliably secure airways quickly, even in the hands of complete novices. The SAD were much more effective than ETI, which often failed, and were even superior to mouth-to-mouth ventilation. SAD may thus be an appropriate first-line approach to field ventilation.