J Emerg Med
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Randomized Controlled Trial
The specific effect of metronome guidance on the quality of one-person cardiopulmonary resuscitation and rescuer fatigue.
Metronome guidance is a simple and economic feedback method of guiding cardiopulmonary resuscitation (CPR). It has been proven for its usefulness in regulating the rate of chest compression and ventilation, but it is not yet clear how metronome use may affect compression depth or rescuer fatigue. ⋯ Metronome guidance is associated with lower chest compression depth of the first five cycles, while shortening the no-flow fraction and the ventilation count in a simulated one-person CPR model. Metronome guidance does not have an obvious effect of intensifying rescuer fatigue.
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Comparative Study
Comparison of type and severity of major injuries among undertriaged and correctly triaged older patients.
Despite the use of prehospital triage algorithms and other trauma scoring methods, a substantial proportion of older patients with life-threatening injuries are undertriaged, increasing the risk of preventable death and disability. ⋯ The large number of undertriaged patients with AIS 3, 4, and 5 injuries underscores the need for a thorough search for life-threatening injuries among older adults who present to non-trauma center Emergency Departments after motor vehicle collisions.
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The Ventriloscope® (Lecat's SimplySim, Tallmadge, OH) is a modified stethoscope used as a simulation training device for auscultation. ⋯ Simulation training using a modified stethoscope in conjunction with standardized patients allows for realistic learning of heart and lung sounds. This technique of simulation training achieved proficiency and better retention of heart and lung sounds in a safe teaching environment.
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Comparative Study
Comparison of sitting face-to-face intubation (two-person technique) with standard oral-tracheal intubation in novices: a mannequin study.
Few studies have evaluated the impact of the upright position on the success of oral-tracheal intubation. Yet, for patients with airway difficulties (i.e, active intraoral bleeding or morbidly obese), the upright position may both benefit the patient and facilitate intubation. ⋯ Subjects were significantly more successful at performing and preferred the sitting face-to-face intubation when compared to standard intubation.
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Electrocardiograms (ECGs) are performed by humans, and thus are subject to human error. An underappreciated source of electrocardiographic abnormality is electrode misconnection, both limb and precordial, and improper placement, which is principally an issue with the precordial electrodes due to anatomic variation. Patterns of abnormality exist; recognition allows the emergency physician to avoid mistaking the resulting electrocardiographic findings for true pathology. ⋯ The hallmarks of electrode misconnection, misplacement, and electrocardiographic artifact can be easily mastered by the Emergency Physician; recognition of these findings can positively impact patient care by avoiding unnecessary intervention secondary to misattribution of findings on the 12-lead ECG to cardiac pathology.