Journal of accident & emergency medicine
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Comparative Study
Can the full range of paramedic skills improve survival from out of hospital cardiac arrests?
To examine the effect of full implementation of advanced skills by ambulance personnel on the outcome from out of hospital cardiac arrest. ⋯ No improvement in survival was demonstrated with more advanced prehospital care.
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To test the hypothesis that limited paramedic advanced life support skills afford no advantage in survival from cardiac arrest when compared with non-paramedic ambulance crews equipped with defibrillators in an urban environment; and to investigate whether separate response units delayed on scene times. ⋯ The interventions of greatest benefit in out of hospital cardiac arrest are basic life support and defibrillation. Additional skills are of questionable benefit and may detract from those of greatest benefit.
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Comparative Study
The misdiagnosis severity score and doctors' perception of the severity of diagnostic errors.
To test the previously described misdiagnosis severity score (MSS) by comparing it with doctors' perceptions of the severity of diagnostic errors. ⋯ It is reasonable to use the MSS as a measure of the severity of diagnostic errors.
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Case Reports
MDMA induced hyperthermia: a survivor with an initial body temperature of 42.9 degrees C.
A young male survived hyperpyrexia (42.9 degrees C) following MDMA ("Ecstasy") ingestion. He developed convulsions, rhabdomyolysis, metabolic acidosis, and respiratory failure. This was successfully managed by assisted ventilation, aggressive fluid therapy, and the early administration of dantrolene, in addition to cooling measures. This is the first report of a survivor with such a severe hyperpyrexia.
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To assess the value of a cardiac technicians' report on electrocardiographs (ECGs) in reducing serious errors of interpretation by senior house officers. ⋯ When cardiac technicians provide a report on an ECG at the time of its recording, serious errors of interpretation by senior house officers are reduced.