Emergency (Tehran, Iran)
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Emergency (Tehran, Iran) · Jan 2017
Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit.
Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans' lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. ⋯ The protocol adherence in management of severe sepsis and septic shock for urine output measurement, central venous pressure monitoring, administration of inotrope agents, blood transfusion, intravenous antibiotic and hydration therapy, and high flow O2 delivery were disappointingly low. It seems training workshops and implementation of Clinical audit can improve residents' adherence to current standard guidelines regarding severe sepsis and septic shock.
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Emergency (Tehran, Iran) · Jan 2017
Valsalva maneuver using a Handmade Device in Supraventricular Tachycardia Reversion; a Quasi Experimental Study.
The use of vagal nerve stimulation is identified as a proper treatment option in patients with stable supraventricular tachycardia (SVT). This study aimed to assess the success of Valsalva maneuver via a handmade device in reversion of SVT. ⋯ Based on the results of the present study, the success rate of Valsalva maneuver with the mentioned handmade device was calculated to be 14.8%. The only independent related factor of successful reversion was SVT history.
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Emergency (Tehran, Iran) · Jan 2017
Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation.
Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. ⋯ The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.
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Emergency (Tehran, Iran) · Jan 2017
Pan vs. Selective Computed Tomography Scans in Management of Multiple Trauma Patients; a Brief Report.
Using pan or selective computed tomography (CT) scan in management of multiple trauma patient is a matter of debate. Therefore, the present study was designed aiming to compare the findings of pan and selective CT scans in management of multiple trauma patients. ⋯ Based on the results of the present study, it seems that doing selective CT scan yields results similar to pan CT in detection of head and face, neck and abdomen and hip injuries in multiple trauma patients. However, using pan CT in these patients led to 16% increase in detection and diagnosis of traumatic intra-thoracic injuries.
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Emergency (Tehran, Iran) · Jan 2017
Screening Characteristics of Bedside Ultrasonography in Confirming Endotracheal Tube Placement; a Diagnostic Accuracy Study.
Confirmation of proper endotracheal tube placement is one of the most important and lifesaving issues of tracheal intubation. The present study was aimed to evaluate the accuracy of tracheal ultrasonography by emergency residents in this regard. ⋯ The present study showed that tracheal ultrasonography by trained emergency medicine residents had excellent sensitivity (>90%) and good specificity (80-90) for confirming endotracheal tube placement. Therefore, it seems that ultrasonography is a proper screening tool in determining endotracheal tube placement.