Practical Summaries in Acute Care Archives – April 1, 2004

April 1, 2004

• LMWHs Appear Equivalent to Unfractionated Heparin for PE

  In this study, the authors performed a meta-analysis of 12 randomized trials comparing the treatment of acute pulmonary embolism (PE) with standard unfractionated heparin or one of a variety of low molecular-weight heparin (LMWH) agents.

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• Early BNP Measurement Yields More Efficient ED Care

  This randomized, controlled, single-blinded study examined the hypothesis that rapid measurement of B-type natriuretic peptide levels (BNP) would improve the care of patients presenting to the emergency department with acute dyspnea.

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• Vasopressin vs. Epinephrine in Cardiac Arrest

  From 1999 to 2002, these Austrian investigators randomly assigned adults with out-of-hospital cardiac arrest to receive two injections of either vasopressin or epinephrine, followed by additional treatment with epinephrine, if needed. The primary endpoint was survival to hospital admission, and the secondary endpoint was survival to discharge from the hospital.

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• Major Trauma and GCS of 3: Do Pupillary Characteristics Give Prognostic Clues?

  This study from Lehigh Valley Hospital in Pennsylvania sought to determine whether admission Glasgow Coma Scale score (GCS), pupil size, and pupil reactivity are sufficient to predict outcomes of major trauma patients.

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• Suspicious Powder Episodes and the ED

  The next time you are in the ED and have a quiet moment, review your hazardous material protocols. Imagine a scenario where, by terror attack, terror hoax, or public fear, an asymptomatic individual (or individuals) brings to you a suspicious powder or substance. Is there a rational approach to handling this situation?

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• ECG Review: What’s Going On? (Part II)

  The 12-lead ECG and accompanying rhythm strip in the Figure were obtained from an 84-year-old man who presented to the emergency department with acute dyspnea from pneumonia and heart failure. Can you account for the relatively slow heart rate despite his acute shortness of breath?

  Read more about ECG Review: What’s Going On? (Part II) - Practical Summaries in Acute Care Archives – April 1, 2004