Important though not to rush to cause and effect – a higher PaCO2 may simply reflect better systemic perfusion and thus the greater offloading of tissue PaCO2 in those recovering better after their arrest, or similar reflection of systemic cellular metabolic function vs dysfunction.
In patients resuscitated after out-of-hospital cardiac arrest, mean 24 hour PaCO2 predicted good outcome, specifically time spent with PaCO2 > 45 mmHg. No similar associations could be found between mean 24 h PaO2 and outcome.
Pre-hospital 12-lead ECG may improve short-term mortality and time to primary cardiac intervention in patients suffering acute myocardial infarct.
Survival after compression-only CPR is comparable to standard CPR if the cause of arrest is cardiac.
Comparing PECARN, CATCH, and CHALICE Rules for Children With Minor Head Injury along with two modalities of physician judgement showed significant variation in the sensitivities and specificities of the five modalities. Only physician practice and PECARN identified all traumatic brain injuries at a cost of lower specificity compared with CHALICE.
Initiating therapeutic hypothermia for out-of-hospital cardiac arrest pre-hospital does not improve survival or neurological outcome.
For emergency medical services with low VF survival rates (<20%), early rhythm analysis improves survival, whereas in services where VF survival rates are high (>20%) delayed rhythm analysis with focus on immediate CPR instead improves survival.
Modelling implementation of a clinical decision rule to identify children at very low risk of significant intra-abdominal injury after blunt trauma:
- Saved on average US$55 per child.
- Avoided a CT scan in 1 in 10 children.
- Missed 1 in 2,000 intra-abdominal injuries requiring acute intervention.
After reviewing available evidence the Neuropathic Pain Special Interest Group could only recommend:
- Epidural injections for herpes zoster neuropathic pain.
- Steroid injections for radiculopathy.
- Spinal cord stimulator for failed back surgery syndrome or Complex Regional Pain Syndrome type 1
The NICOM non-invasive cardiac output monitor is non-inferior to oesophageal doppler monitoring for guiding fluid therapy in colorectal surgery.