Læknablađiđ
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Since 1982 an emergency ambulance manned by a physician and two emergency medical technicians has been operated in the Reykjavik area. The physicians have followed guidelines from the American Heart Association (AHA). Until 1986 the AHA guidelines had bicarbonate and in some instances calcium as first line treatment in cardiopulmonary resuscitation (CPR). ⋯ When sudden cardiorespiratory arrest is witnessed the probability of survival is multiplied. We conclude that the results of ACLS outside the hospital in Reykjavik and surrounding area continue to be among the best. Changes in ACLS guidelines do not appear to have increased survival.
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Third degree atrioventricular block is considered present when none of the atrial impulses are conducted to the ventricles because of a disruption in the conducting system. Third degree atrioventricular block is usually considered a serious sign but most studies have been performed on hospitalized patients or certain professional groups. The objective of this study was to find the prevalence of third degree atrioventricular block in a representative population sample and estimate its prognostic significance. ⋯ The prevalence of third degree atrioventricular block in this general population was low but nevertheless considerably higher than previously reported. The block was temporary in the majority of subjects. All had some underlying heart disease which seemed to affect the prognosis more than the heart block. In this survey fewer subjects than expected were found to need a pacemaker.
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Muscle relaxants have been used during anesthesia for the past 50 years but in the last decades it has been realised that their use can lead to complications. Studies have shown 20-40% incidence of restcurarization in postanesthesia care units (PACU) even if neuromuscular monitors are used during anesthesia. The purpose of this study was to estimate the frequency of postoperative muscle weakness at the Reykjavik Hospital in Iceland. ⋯ The study shows that the incidence of muscle weakness is too high, which might increase the risk for complications such as hypoxia or respiratory failure. To increase patient safety, shorter acting drugs are recommended and the use of new nervestimulators giving the train-of-four(TOF)-ratio during muscle blockade could possibly improve the situation.
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The Health Centre at Kirkjubaejarklaustur serves a large rural district with a population a little over 600. Agriculture and various services including tourism are the main occupations. Almost 20% of the population are over 65 years of age, which is an unusually high figure compared to the rest of the country. Ambulance transports are one of the health centre's responsibilities. Most of these are surface transports to hospitals, 200-250 kilometres away. ⋯ Ambulance transport including the preparation of the sick or injured person is an important part of health care in this region. General practitioners need to be well versed in emergency medicine and ambulance attendants in preparing the patient for transport. Therefore continuing education is an important factor in this discussion. Tourism in the summertime may prompt the need for increased staffing in the health care sector. There is no indication that helicopter transport will replace surface transport in the near future except in special cases as it has been. Good primary health care and regular access to physicians in the nursing home setting decrease the need for ambulance transport. Further studies in the area of ambulance transport especially concerning tourists and the elderly are needed in the Icelandic context. Both groups are on increase and will probably be more in demand of emergency medical services such as ambulance transports.
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Due to widespread access to hot water in Iceland it has been suspected that the incidence of burn injury is higher compared to other countries. The epidemiology of severe burn injury needing hospitalization was studied. ⋯ We conclude that it should be possible to reduce the risk of severe burn injuries in Iceland through education campaigns and also by legislating maximum temperature of the tap-water at 52-54 degrees C.