Annals of emergency medicine
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The development of modern cardiopulmonary resuscitation (CPR) is an exciting and surprising history to modern health professionals who rarely are aware of how new CPR really is. Artificial respiration began in the 16th century with Vesalius's work on living animals; progressed with the rise and fall of mouth-to-mouth, manual, and positive pressure ventilation methods of the 18th and 19th centuries; and culminated in 1958 with demonstration of the superiority of the mouth-to-mouth technique. ⋯ The technique was applied to man internally in 1947 and externally in 1956. The simultaneous use of all these modern CPR methods dates back only 20 years.
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The increasing emphasis on the emergency physician's role in the community led us to investigate the role of residency training programs in providing more than clinical competence to their graduates. Using guidelines provided by the American College of Emergency Physicians, the Joint Commission on Accreditation of Hospitals, the Department of Health, Education and Welfare, and program alumni, we set about to determine methods of enhancing the EMS and administrative aspects of the residency program at Charity Hospital. We describe the curriculum that was developed.
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Traumatic rupture of the tracheobronchial tree is an increasingly occurring complication of blunt chest trauma. Early detection and surgical repair are important for definitive and successful reconstruction. ⋯ Use of a rigid bronchoscope is difficult and traumatic to the patient, and the flexible fiberoptic bronchoscope, with its greater technical simplicity, is more easily applied. We report the case of a patient who suffered bronchial stenosis and total atelectasis before discovery of a fracture was made.
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A tracheal-esophageal airway for field or hospital use is described. The airway consists of a clear plastic mask and endotracheal low pressure cuffed tube with a Murphy tip. ⋯ The endotracheal tube is attached to the mask by a tubular coupler and easily disconnected by removing a metal clip in the event of tracheal insertion of the tube. Our four-year experience with the tracheal-esophageal airway in 400 cardiac arrests has shown it to be safe, simple, and useful.