Emergency medicine journal : EMJ
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The emergency medical dispatcher (EMD) receiving a call via 911 is the first point of contact within the acute care system and plays an important role in early stroke recognition. Published studies show that the diagnostic accuracy of stroke of EMD needs to be improved. ⋯ However, the ability of EMD and 911 callers to use this in real time has not been reported. The goal of this pilot study was to determine the feasibility of an EMD applying the Cincinnati stroke scale tool during a 911 call, and to report the time required to administer the tool.
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The aim of the study was to compare symptom-triggered and standard benzodiazepine regimens for the treatment of alcohol withdrawal syndrome in an emergency department clinical decision unit. The authors found that the symptom-triggered approach reduced cumulative benzodiazepine dose and length of stay.
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Many studies over the past decade have investigated delaying initial defibrillation to perform cardiopulmonary resuscitation (CPR), as it has been associated with increased rates of restoration of spontaneous circulation and/or survival. Since 2006, a number of studies have investigated these procedures. The objective of this study was to undertake a literature review examining the commencement of CPR before defibrillation in the out-of-hospital setting. ⋯ Conflicting evidence remains regarding the benefit of CPR before defibrillation. The establishment of a consistent timeframe of chest compressions before defibrillation in the out-of-hospital setting will provide uniformity in standards in clinical practice and education and training.
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A short cut review was carried out to establish whether whole body ice immersion was an effective way of cooling in patients presenting with heat stroke. One systematic review and three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line was that immersion in ice-water was the most effective modality of lowering core body temperature in exertional heatstroke and shivering and vasoconstriction concerns were unfounded.