Management of Periprosthetic Polyvinyl Alcohol Synthetic Cartilage Implant Infection with Staged First Metatarsophalangeal Joint Arthrodesis.

Surgical management of hallux rigidus using a polyvinyl alcohol synthetic cartilage implant has gained popularity among foot and ankle surgeons. Although uncommon, appropriate diagnosis and management of a periprosthetic implant infection is critical in limiting morbidity. We present a case report and staged technique for converting a first metatarsal synthetic cartilage hemiarthroplasty to arthrodesis in the setting of a periprosthetic joint infection.

A review of chest compression interruptions during out-of-hospital cardiac arrest and strategies for the future.

Background: It has been known for many years that interrupting chest compressions during cardiopulmonary resuscitation (CPR) from out-of-hospital cardiac arrest (OHCA) leads directly to negative outcomes. Interruptions in chest compressions occur for a variety of reasons, including provider fatigue and switching of compressors, performance of ventilations, placement of invasive airways, application of CPR devices, pulse and rhythm determinations, vascular access placement, and patient transfer to the ambulance. Despite significant resuscitation guideline changes in the last decade, several studies have shown that chest compressions are still frequently interrupted or poorly executed during OHCA resuscitations.

A phased approach to cardiac arrest resuscitation involving ventricular fibrillation and pulseless ventricular tachycardia.

With the release of the 2010 American Heart Association (AHA) Guidelines for cardiopulmonary resuscitation and emergency cardiac care, evidence regarding management of out-of-hospital cardiac arrest suggests a more fundamental approach. To aid in understanding and learning, this article proposes a method that optimizes the timing and delivery of evidence-proven therapies with a 3-phase approach for out-of-hospital resuscitation from ventricular fibrillation and pulseless ventricular tachycardia. Although this model is not a new concept, it is largely based on the 2010 AHA Guidelines, enhancing the philosophy of the "CAB" concept (Chest compressions/Airway management/Breathing rescue).

Impact of the 12-lead electrocardiogram on ED evaluation and management.

Study Objective: This study was conducted to assess the impact (diagnostic, therapeutic, and disposition) of the 12-lead electrocardiogram (ECG) on emergency department (ED) patient evaluation and management.

Methods: This project was a prospective study of a convenience sample of 304 ED patients undergoing ECG analysis during their evaluation in the ED of a level 1 trauma center. The data collection for this study was divided into 4 parts.

Disagreement between transport team and ED staff regarding the prehospital assessment of air medically evacuated scene patients.

Study Objective: To determine the rate of disagreement in assessment of significant illness or injury between air medical transport team assessment and emergency department (ED) diagnosis in patients transferred from the scene of an incident to the ED.

Methods: Retrospective analysis was performed on 84 patients transported by medical flight teams from an accident scene to an ED.

Results: Results show transport team assessment concurred with ED diagnosis 96.

The prehospital 12-lead electrocardiogram: impact on management of the out-of-hospital acute coronary syndrome patient.

The electrocardiogram (ECG), when applied in the prehospital setting, has a significant effect on the patient with chest pain. The potential effect on the patient includes both diagnostic and therapeutic issues, including the diagnosis of acute myocardial infarction (AMI) and the indication for thrombolysis. The prehospital ECG may also detect an ischemic change that has resolved with treatment delivered by emergency medical services (EMS) prior to the patient's arrival in the emergency department (ED).