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By Noah Alexander Emerg resident
Jean-Jacques Parienti, Nicolas Mongardon, Bruno Mégarbane, Jean-Paul Mira, Pierre Kalfon, Antoine Gros, Sophie Marqué, Marie Thuong, Véronique Pottier, Michel Ramakers, Benoît Savary, Amélie Seguin, Xavier Valette, Nicolas Terzi, Bertrand Sauneuf, Vincent Cattoir, Leonard A Mermel, Damien du Cheyron
BACKGROUND: Three anatomical sites are commonly used to insert central venous catheters, but insertion at each site has the potential for major complications. METHODS: In this multicenter trial, we randomly assigned nontunneled central venous catheterization in patients in the adult intensive care unit (ICU) to the subclavian, jugular, or femoral vein (in a 1:1:1 ratio if all three insertion sites were suitable [three-choice scheme] and in a 1:1 ratio if two sites were suitable [two-choice scheme])...
September 24, 2015: New England Journal of Medicine
Anil George, Pradeep S Arumugham, Vincent M Figueredo
Electrocardiography continues to be a focal point of modern medicine, and the electrocardiogram (ECG) continues to be the most frequently ordered cardiac test. Most of the clinical importance of the ECG rests on the invaluable information it renders in diagnosing acute coronary syndromes and cardiac arrhythmias. However, the ECG is a valuable tool and diagnostic aid in the evaluation of many other conditions such as pericarditis and pulmonary embolism. Of the electrocardiographic leads, aVR has traditionally received less attention in clinical evaluation of the ECG...
2010: Experimental and Clinical Cardiology
Devin Harris, Christopher Hall, Kevin Lobay, Andrew McRae, Tanya Monroe, Jeffrey J Perry, Anthony Shearing, Gabe Wollam, Tom Goddard, Eddy Lang
The CAEP Stroke Practice Committee was convened in the spring of 2013 to revisit the 2001 policy statement on the use of thrombolytic therapy in acute ischemic stroke. The terms of reference of the panel were developed to include national representation from urban academic centres as well as community and rural centres from all regions of the country. Membership was determined by attracting recognized stroke leaders from across the country who agreed to volunteer their time towards the development of revised guidance on the topic...
March 2015: CJEM
Peiman Nazerian, Giovanni Volpicelli, Simone Vanni, Chiara Gigli, Laura Betti, Maurizio Bartolucci, Maurizio Zanobetti, Francesca Romana Ermini, Cristina Iannello, Stefano Grifoni
OBJECTIVES: Despite emerging evidences on the clinical usefulness of lung ultrasound (LUS), international guidelines still do not recommend the use of sonography for the diagnosis of pneumonia. Our study assesses the accuracy of LUS for the diagnosis of lung consolidations when compared to chest computed tomography (CT). METHODS: This was a prospective study on an emergency department population complaining of respiratory symptoms of unexplained origin. All patients who had a chest CT scan performed for clinical reasons were consecutively recruited...
May 2015: American Journal of Emergency Medicine
James R Miner, Johanna C Moore, Erin J Austad, David Plummer, Laura Hubbard, Richard O Gray
STUDY OBJECTIVE: We compare the frequency of airway and respiratory adverse events leading to an intervention between propofol with 1:1 and 4:1 mixtures of propofol and ketamine (ketofol). METHODS: We performed a randomized, double-blinded trial in which emergency department adults undergoing deep sedation received propofol, 1:1 propofol and ketamine, or 4:1 propofol and ketamine. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention...
May 2015: Annals of Emergency Medicine
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