Emergency medicine journal : EMJ
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Animal studies describe cardiovascular collapse (CVC; hypotension or reoccurrence of cardiac arrest) after return of spontaneous circulation (ROSC) from cardiopulmonary arrest. Few studies describe CVC in humans. This study aimed to determine the occurrence of CVC in human out-of-hospital cardiopulmonary arrest (OHCA). ⋯ In this series of treated OHCA, only a small fraction of patients experienced CVC after ROSC.
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Therapeutic hypothermia has proved effective in improving outcome in patients after cardiac arrest due to ventricular fibrillation (VF). The benefit in patients with non-VF cardiac arrest is still not defined. ⋯ In this cohort patients undergoing hypothermia treatment after non-shockable cardiac arrest do not benefit significantly concerning neurological outcome. Hypothermia treatment needs to be evaluated in a large multicentre trial of cardiac arrest patients found initially to be in non-shockable rhythms to clarify whether cooling may also be beneficial for other rhythms than VF.
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The aim of this study was to test if Procalcitonin PCT value at the time of admission is a predictor of mortality and/or a diagnostic marker of concomitant infection in exertional heatstroke. ⋯ PCT value at the time of admission is an independent predictor of mortality, but maybe not a good indicator of concomitant infection in exertional heatstroke.
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This study attempted to identify any differences between the outcomes of patients with severe traumatic brain injury (TBI) who were directly transported to Chang Gung Memorial Hospital and those who were stabilised initially at other hospitals in south-central Taiwan. ⋯ No differences in outcome were found between patients with isolated severe TBI who were directly transported and those transferred to this hospital's emergency room.
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Onboard event recorders in vehicles record external and internal video before and after when preset g-force limits are exceeded. The use of these recorders in a fleet of ambulances, along with formal review, may decrease the number of unsafe driving events. The aim of this study was to evaluate the number of driving events since the inception of DriveCam technology in a fleet. ⋯ The institution of video event recorder technology along with formal review and feedback resulted in a change in driving behaviour. Given that call volumes increased and driving events decreased, these measures may serve as surrogates for improvements in safety and maintenance costs. Economic analysis is necessary for conclusions on fiscal impact.