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Prehospital seizure management
Obtaining venous access and administering drugs to terminate seizures is difficult in the prehospital environment. Intramuscular (IM) midazolam is attractive as a potential treatment option for status epilepticus, as the drug is easily stored and can be rapidly administered. A randomised controlled trial from the USA recruited almost 900 patients of all age groups and compared the efficacy of IM midazolam and intravenous lorazepam. The results revealed IM midazolam to be at least as effective as intravenous lorazepam (N Engl J Med 2012;366:591–600).
A potential problem in providing effective chest compressions in basic life support is that increasing the speed of compressions may compromise the ability to maintain effective pressure. Investigating this in a manikin based study, researchers compared the effect of different compression rates on compression quality, including compression depth, duty cycle, leaning and performance fatigue. As expected, with faster compression rates (more than 120/min), there was a decrease in compression depth, a trend towards increased leaning and an increase in early decay. At compression rates between …