Can J Emerg Med
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ABSTRACTObjectives:Pediatric emergency medicine (PEM) physicians receive little opportunity to practice and perform chest tube insertion. We sought to develop and validate a scoring tool to assess chest tube insertion competency and identify areas where training is required for PEM physicians. ⋯ The TACTIC demonstrates good interrater reliability, content validity, and construct validity in assessing a PEM practitioner's skill inserting chest tubes in a simulated setting.
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Clinical questionFollowing transient ischemic attack or acute minor stroke, does the combination of clopidogrel and aspirin reduce the risk of stroke greater than aspirin alone?Article chosenWang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. ⋯ ObjectiveThe primary outcome measured in this study was ischemic or hemorrhagic stroke at 90 days of follow-up in groups assigned to treatment with a combination of aspirin and clopidogrel or aspirin alone following transient ischemic attack or acute minor stroke. The secondary outcomes were new clinical vascular events, including vascular death.
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ABSTRACTExtracorporeal membrane oxygenation (ECMO) is a method to provide temporary cardiac and respiratory support to critically ill patients. In recent years, the role of ECMO in emergency departments (EDs) for select adults has increased. ⋯ Over the next 48 hours following ECMO commencement, the patient's cardiorespiratory function rapidly improved, and he was discharged home 9 days after admission with no neurologic sequelae. The history, indications, and increasing role of ECMO in a range of conditions, including cardiac arrest, are reviewed.