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A physician manned ambulance has provided advanced resuscitation service in the Reykjavík area for over 20 years. Out of hospital resuscitation since 1982 has been done with average response time of 4.6-4.9 minutes, the survival rate to hospital admission has been 31-40% and survival to hospital discharge 16-17%. In the years preceding this study, several changes were done in the service; the service area was enlarged, dispatch was centralized to one emergency number, the training of EMT s and physicians was improved and a two-tier rendezvous system was adopted. Cell phone coverage reached over 90% of the population. The study was done in 1999-2002 with the objective to: 1. measure the results of attempted prehospital resuscitations for cardiac diseases in the area, 2. to monitor the effect of bystander response, 3. to estimate the effect of changes in the service prior to the study period. ⋯ Despite various changes in the EMS system, the results of resuscitative attempts are similar to previous studies in the area but an increased proportion of survivors is left with neurological damage. In 54% of the cases COR was performed by bystanders. Response time needs to be shortened and CPR training increased.
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To investigate changes in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. ⋯ There has been a significant increase in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. It is possible that increased social awareness of obesity during the study period has influenced diagnostic habits of physicians and thus increased the use of obesity as a diagnosis in medical certificates and disability assessment. In all likelihood, however, there has been an increase in disabling obesity in Iceland, indicating that obesity is an increasing public health problem demanding appropriate intervention.
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A retrospective analysis of the epidemiology and intensive care treatment of ARDS in Iceland during the 10 year period, 1988-1997 with observation of trends within the period. ⋯ The incidence of ARDS in a well defined population of Iceland is lower than recent studies in USA and Europe have shown or 5.9 cases/100.00/year but is increasing. The mortality is 40% and shows a slight downward trend, which may be due to the use of lung protective ventilation.
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Practice Guideline
[The new international guidelines for cardiopulmonary resuscitation and emergency cardiovascular care].
Recently the American Heart Association and the European Resuscitation Council published new guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. These new guidelines are the result of extensive review of the scientific literature in this field by The International Liason Committee on Resuscitation. ⋯ The guidelines also promote early defibrillation while the role of pharmacologic therapy during cardiopulmonary resuscitation is not as clear. This article discusses the highlights of the new guidelines.