The journal of the Royal College of Physicians of Edinburgh
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J R Coll Physicians Edinb · Mar 2010
Review Comparative StudyUpdate on cardiopulmonary resuscitation.
Adult cardiopulmonary resuscitation (CPR) has been shown to improve survival for individuals suffering cardiac arrest. Despite this, the delivery of basic life support to victims outside the clinical environment remains poor, particularly as only a minority receive resuscitation. In addition, research continues to examine the optimal techniques for CPR and guidelines have been modified to reflect the latest developments. ⋯ Throughout the guidelines a more pragmatic approach to resuscitation is adopted to try to encourage all individuals, whether trained healthcare professionals or lay people, to initiate resuscitation. An acknowledgement of the reasons why individuals may be reluctant to start resuscitation through fear or anxiety will hopefully help to encourage the instigation of these techniques. This overview will summarise the guidelines and highlight alterations or alternatives where appropriate.
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J R Coll Physicians Edinb · Mar 2010
Current controversies: thrombolysis for patients with acute ischaemic stroke aged over 80.
Stroke is the major cause of disability in the community. Most strokes are due to blocked arteries in the brain. ⋯ However, thrombolysis can cause bleeding into the brain, so the treatment should only be given when the benefits outweigh the risks. Controversy still exists about the risks and benefits in certain groups of patients, and there is variation in practice between stroke physicians, reflecting these uncertainties.
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J R Coll Physicians Edinb · Mar 2010
Comparative StudyThe use of combined physiological parameters in the early recognition of the deteriorating acute medical patient.
Early warning scores (EWS) are widely used to allow early recognition of the deteriorating patient. We aimed to test their ability to predict major deterioration in medical patients. ⋯ Commonly used physiological parameters and existing EWS systems are useful at identifying sick patients. The discriminant functions described here appear to have a role in this setting but require validation in future studies.