Annals of emergency medicine
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To develop a consensus for change in the educational aspects of the Advanced Cardiac Life Support (ACLS) Training Program, the American Heart Association appointed panel members to engage in a consensus process. At a preconference meeting held in the fall of 1991, panel members received broad input from experts in adult education, experienced ACLS educators, and resuscitation scientists. The panel then developed a statement based on the preconference discussions and presented it at the National Conference on CPR and Emergency Cardiac Care held in February 1992. ⋯ The problem learner should be identified as early as possible and should receive intensive remediation to achieve the goal of every participant acquiring the targeted skills and knowledge. Because skill retention is variable, rescuers should practice skills frequently in regular refresher sessions. At a minimum, retraining every two years is strongly recommended.
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Case Reports
Diffuse subcutaneous emphysema, pneumomediastinum, and pneumothorax after dental extraction.
Subcutaneous emphysema, pneumomediastinum, and pneumothorax may result from surgical procedures and trauma and usually do not present a diagnostic dilemma. We present a case of subcutaneous emphysema, pneumomediastinum, pneumothorax, and pneumoretroperitoneum after a dental procedure with an air-and-water-cooled turbine burr drill. ⋯ If a large amount of air is injected, it may track into not only the subcutaneous tissues but also the mediastinum, pleural space, and retroperitoneal space. Patients with significant amounts of air must be admitted, observed for airway compromise, and be provided IV antibiotics and hydration.