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Thomas tube holder in prehospital care ▸
Securing a tracheal tube has long been a challenge in the prehospital setting. This article advocates the use of a “Thomas tube holder”, which was designed to address the problems of inadvertent dislodgement and tube biting. The tube holder comprises a plastic mouthpiece and central tube-clamping hole and comes in adult and paediatric sizes. The author proposes its use with laryngeal mask airway in addition to tracheal tubes.
Treatment of pulmonary oedema ▸
This randomised controlled trial from Brazil compared continuous positive airway pressure (CPAP), non-invasive bilevel ventilation, and standard oxygen therapy on the tracheal intubation rate in patients with cardiogenic pulmonary oedema in the emergency department. The results revealed a significantly higher intubation rate in the group treated with standard oxygen therapy (42%) compared with the CPAP or bilevel (7% in both). However, the study was not powerful enough to be able to properly compare bilevel with CPAP in the treatment of cardiogenic pulmonary oedema.
Magnesium sulphate for asthma in children ▸
The role of intravenous magnesium sulphate in treating acute moderate to severe asthma in children remains controversial. The primary outcome measure considered in this meta-analysis was its effectiveness in preventing admission to hospital. A total of five trials from emergency departments were included, all of which were judged to be of good quality. The dosing regimes did vary across the studies, but the results indicated that magnesium sulphate was effective in preventing admission to hospital.
Procalcitonin as a marker of meningococcal sepsis ▸
This prospective observational study from Alder Hey Hospital examined the profiles of different inflammatory markers in 94 children …