The American journal of emergency medicine
-
In order to determine whether paramedics could be effectively trained in the skill of orotracheal intubation, 11 paramedics were entered into a pilot study. All paramedics received the same limited didactic, cadaver, and in vivo clinical preparation. ⋯ Subsequently, training has been expanded to a large number of paramedics, and the experience with intubation now includes a total of 128 patients and an overall success rate of 86%. It is concluded that paramedics can safely and effectively perform orotracheal intubation in a variety of adverse field conditions.
-
We report a case of a 78-year-old woman, previously in good health, who was endotracheally intubated and brought to the emergency department following sudden cardiac arrest. Physical examination revealed absent breath sounds over the right hemithorax, and a portable chest radiograph demonstrated left mainstem bronchus intubation. Although right mainstem bronchus intubation is a common complication of endotracheal intubation, left mainstem bronchus intubation is rare.
-
Perfusion of the cerebral cortex (rCCBF) during resuscitation from cardiac arrest was studied using 24 large dogs and three different resuscitation models. Conventional cardiopulmonary resuscitation (CPR) was compared with interposed abdominal compression CPR (IAC-CPR) and with IAC-CPR together with infusion of epinephrine. ⋯ With epinephrine, IAC-CPR produced rCCBF (0.93 +/- 0.49 ml/min/g) statistically indistinguishable from normal. Both models of IAC-CPR were significantly superior to conventional CPR in perfusion of the cerebral cortex.