Point-of-care ultrasound thoracic "Quick Look" identifies potentially dangerous chest tube insertion sites.

Purpose: Emergency and trauma physicians typically rely on anatomic landmarks to determine the proper intercostal space for emergent tube thoracostomy. However, physicians using this technique select a potentially dangerous insertion site too inferior in nearly one-third of cases, which have the potential to result in subdiaphragmatic puncture. We investigated a point-of-care ultrasound (POCUS) thoracic "Quick Look" procedure as a technique to allow visualization of underlying structures to avoid tube misplacement.

A Multicenter, Prospective Study Comparing Subxiphoid and Parasternal Views During Brief Echocardiography: Effect on Image Quality, Acquisition Time, and Visualized Anatomy.

Background: Recent literature has suggested echocardiography (echo) may prolong pauses in chest compressions during cardiac arrest.

Objectves: We sought to determine the impact of the sonographic approach (subxiphoid [SX] vs. parasternal long [PSL]) on time to image completion, image quality, and visualization of cardiac anatomy during echo, as performed during Advanced Cardiac Life Support.

Ultrasound Visualization of Atypical Abscess Ultimately Containing Bot Fly Larva.

Background: Because of the rise in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), presentations to the emergency department for the evaluation of cutaneous abscesses have risen dramatically over the past 2 decades. Soft tissue point of care ultrasound (POCUS) differentiates abscess from cellulitis, determines the size and shape, and characterizes the contents of the abscess. It has been shown to improve medical decision-making and therefore the emergency management of cutaneous abscesses over physical examination alone.

Identification of fall risk factors in older adult emergency department patients.

Objectives: Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6-month fall risk in community-dwelling older adults discharged from the emergency department (ED).

Descriptive analysis of 258 emergency department visits by spina bifida patients.

To provide a descriptive analysis of emergency department (ED) patients with spina bifida, a retrospective chart review was conducted of ED patients with spina bifida. Data describing demographics, chief complaints, diagnostics, diagnoses, and disposition were collected. There were 125 patients with 258 ED visits.

Bacteremic elder emergency department patients: procalcitonin and white count.

Objectives: To assess serum procalcitonin (PCT) and white blood cell (WBC) count in detecting bacteremia in elder emergency department (ED) patients.

Methods: A prospective, observational study of ED patients aged > or =65 years in whom blood cultures were drawn was conducted at an urban, tertiary care, academic ED. Serum for PCT and WBC count was obtained at the time of ED visit.

Primary aortoenteric fistula in the Emergency Department.

A primary aortoenteric fistula is a rare, life-threatening cause of gastrointestinal bleeding. Primary aortoenteric fistula results most commonly from an abdominal aortic aneurysm, with the fistula forming most often between the aorta and the third portion of the duodenum. Often, the classic triad of abdominal pain, gastrointestinal bleeding, and pulsatile mass is absent.

Attitudes towards CPR training and performance in family members of patients with heart disease.

Considering that heart patients may be at higher risk for cardiac arrest, this study was conducted to evaluate the preparedness and willingness of cardiac patient family members to perform cardiopulmonary resuscitation (CPR). A cross-sectional survey of 100 family members of cardiac patients was conducted at a tertiary care emergency department over a 1.5-month period.

Scaling structure of electrocardiographic waveform during prolonged ventricular fibrillation in swine.

Ventricular fibrillation (VF) is the most common arrhythmia causing sudden cardiac death. However, the likelihood of successful defibrillation declines with increasing duration of VF. Because the morphology of the electrocardiogram (ECG) waveform during VF also changes with time, this study examined a new measure that describes the VF waveform and distinguishes between early and late VF.

Evaluation of biphasic transthoracic defibrillation in an animal model of prolonged ventricular fibrillation.

Objectives: To determine whether a biphasic defibrillation waveform (BDW) would produce a superior rate of converting prolonged ventricular fibrillation (VF) into a perfusing rhythm and delay the occurrence of asystole and/or pulseless electrical activity (PEA) during the resuscitation attempt, when compared with a monophasic defibrillation waveform (MDW).

Methods: The authors performed a prospective, randomized, blinded experiment using an established swine model of prolonged VF. Thirty-four mixed-breed domestic swine (mean mass 22.

Endotracheal drug delivery followed by a 90-degree torso tilt in a swine model of cardiac arrest.

Objectives: Prehospital providers are often unable to obtain intravenous (i.v.) access in cardiac arrest victims.

Effect of standard-dose versus high-dose epinephrine on myocardial high-energy phosphates during ventricular fibrillation and closed-chest CPR.

Study Objective: To evaluate the effects of standard-dose versus high-dose epinephrine on myocardial high-energy phosphate metabolism during resuscitation from cardiac arrest.

Design: Prospective, nonrandomized, controlled study using a swine model of cardiac arrest and resuscitation.

Interventions: After anesthesia, intravascular pressure instrumentation, and ten minutes of ventricular fibrillation arrest, closed-chest CPR was begun.