Ugeskrift for laeger
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This systematic approach to the immediate assessment and treatment of the critically ill or injured patient is applicable in all clinical emergencies. The aim of the ABCDE approach is to facilitate immediate life-saving treatment and thus buy time for definite diagnosis and treatment by breaking down complex clinical situations into manageable parts. Application of the ABCDE approach may improve treatment quality.
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To identify users and use of opioids in Denmark three databases were combined. The latest fifteen years an increase in users has been noted, and the costs of opioids have increased from 175 million DKK (1994) to 540 million DKK (2008). Oxycodone and transdermal fentanyl constitute 60% of the total annual costs, and together with the increasing costs of buprenorphine, the three opioids constitute 70% of the total costs in the primary health care sector. The largest group of users is individuals with acute pain, however, the highest consumption is generated by individuals with chronic non-malignant pain.
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Efficient cardiopulmonary resuscitation (CPR) contributes to improved outcome after cardiac arrest. New mechanical devices improve cardiac output. We present a case-report with a male patient who was admitted after 55 minutes of out-of-hospital CPR which was followed by 45 minutes of in-hospital CPR with a mechanical device (LUCAS). ⋯ The patient was later discharged without neurological deficits. Adequate mechanical massage during CPR may improve survival. However, randomised clinical trials are warranted.
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Ugeskrift for laeger · Nov 2010
Case Reports[Automatic mechanical chest compression during helicopter transportation].
We describe a case story with a drowned, hypothermic trauma patient treated with an automatic mechanical chest compression device during helicopter transportation to a trauma center. After falling from a 25 meter high bridge into 2 °C water, she was rescued lifeless 17 minutes later. ⋯ Upon arrival to a trauma centre approx. 60 minutes later, the patient was treated with extracorporal circulation and rewarmed. She was eventually discharged to her home with minor loss of cerebral function.