Articles: emergency-services.
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Randomized Controlled Trial Comparative Study
Comparison of manual and mechanical chest compression techniques using cerebral oximetry in witnessed cardiac arrests at the emergency department: A prospective, randomized clinical study.
We aimed to compare regional cerebral oxygen saturation (rSO2) levels during cardiopulmonary resuscitation (CPR), performed either manually or using a mechanical chest compression device (MCCD), in witnessed cardiac arrest cases in the emergency department (ED), and to evaluate the effects of both the CPR methods and perfusion levels on patient survival and neurological outcomes. ⋯ A relationship between ROSC and high rSO2 levels in witnessed cardiac arrests exists. Monitoring rSO2 levels during CPR would be useful in CPR management and ROSC prediction. During CPR, MCCD or manual chest compression has no distinct effect on oxygen delivery to the brain.
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Randomized Controlled Trial
Predictors of Older Adult Adherence with Emergency Department Discharge Instructions.
Older adults discharged from the emergency department (ED) are at high risk for adverse outcomes. Adherence to ED discharge instructions is necessary to reduce those risks. The objective of this study is to determine the individual-level factors associated with adherence with ED discharge instructions among older adult ED outpatients. ⋯ Older adults discharged home from the ED have mixed rates of adherence to discharge instructions. Although it is thought that some subgroups may be higher risk than others, given the opportunity to improve ED-to-home transitions, EDs and health systems should consider providing additional care transition support to all older adults discharged home from the ED.
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Randomized Controlled Trial
The effect of emergency manuals on team performance during two different simulated perioperative crises: A prospective, randomized controlled trial.
Whether having an emergency manual (EM) available for use during perioperative crises enhances or detracts from team performance, especially for multi-factorial diagnostic situations that do not explicitly match a chapter of the EM. ⋯ Providing an EM did not affect team performance in areas like diagnosis, treatment, fluid resuscitation, communication, and teamwork in management of perioperative crises such as transfusion reaction where an explicit chapter in the EM exists and refractory hypotension / septic shock where an explicit chapter does not exist. A suggestion of improved cardiac arrest resuscitation with the availability of an EM was found, but should be interpreted with caution given a limited sample size. Observed actions using the EM demonstrated that only about half of the teams used the EM to any substantive degree and most used it relatively late in the crisis. By observation, the EM appeared to be helpful in about half of the cases and did not, by itself, deter from appropriate management.
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Randomized Controlled Trial
Use of Tablet Video for Delivery of Neonatal Discharge Instructions to First-Time Parents.
While video discharge instructions have been shown to improve retention of information and patient satisfaction, data are limited regarding patient perceptions of video tools. ⋯ Broader use of technology may allow for a more standardized approach to patient education and improve efficiency for clinicians, without compromising patient satisfaction and confidence in caring for themselves and their dependents.
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Randomized Controlled Trial
Treatment of migraine attacks by transcutaneous electrical nerve stimulation in emergency department: A randomize controlled trial.
The primary purpose of this trial is to evaluate the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy application in the emergency department. ⋯ TENS therapy is a fast-acting, effective therapy for the treatment of acute migraine in the emergency department.