Annals of emergency medicine
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Ventricular fibrillation was induced in nine dogs weighing 18 to 22 kg. CPR was performed with a mechanical chest compressor. Mean carotid flow during CPR was 7.9 +/- 1.5 ml/min. ⋯ One liver laceration and two gallbladder contusions were noted at autopsy. MAST inflation apparently augments carotid flow an systolic pressure. Variations in intrapleural pressure do not seem to have a significant influence on CPR.
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Levels of nitrous oxide were monitored in the emergency department during the use of a Nitronox machine after four and eight minutes of breathing gas. Levels near the user's head were found to be 800 to 1,200 parts per million. ⋯ Ventilation was measured in the test room and was found to influence the peak level of nitrous oxide and the rapidity of washout of the gas from the room. The results of this study should prompt the development of guidelines for the use of nitrous oxide in the emergency department setting.
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In an attempt to establish prognostic indicators for ultimate long-term survival following advanced life support (ALS), a two-year (1978-79) retrospective study was made of 92 survivors. The survivors were divided into two groups: the first survived admission to the intensive care unit, but subsequently died in the hospital; the second survived to ultimate discharge from the hospital. ⋯ This article advances the definition of ultimate survival of ALS to mean discharge of the patient from the hospital, and advocates this as the most objective evaluation of successful ALS. The article furthermore offers duration of ALS as an effective prognostic indicator of a patient's chance for ultimate survival.
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The case of a scuba diver who suffered a cardiac arrest is presented. The history of a short, lucid interval after surfacing followed by cardiac arrest, the finding of hemoptysis, and the characteristic response to recompression therapy are consistent with the diagnosis of gas embolism. The clinical presentation and pathophysiology of gas embolism are discussed, and an approach to emergency stabilization and definitive management of gas embolism is reviewed, with emphasis on cardiac arrest.