Resuscitation
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Many studies (several even before American Heart Association recommended in 1973 that lay public be trained in cardiopulmonary resuscitation (CPR] have documented that retention of CPR skills is poor, unaffected by modifications in curriculum or whether the students are lay or professional. We chose to investigate what actually occurs during a CPR course, and gained the following insights: despite clearly defined curricula, we found that instructors did not teach in a standardized way. Practice time was limited and errors in performance were not corrected. ⋯ As a result of these studies, we discovered that the problem of poor retention of CPR skills may lie not with the learner or the curriculum, but with the instructor. But, since lives are being saved with bystander CPR, does this documented poor retention matter? Perhaps the solution is not only to improve instructor training to make certain that students receive adequate practice time and accurate skill evaluation, but also to modify the criteria for correct performance when testing for retention. These criteria should be based on the minimum CPR skills that are required to sustain life for the critical 4-8 min before defibrillation and other advanced cardiac life support are delivered.
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Review Comparative Study
Direct mechanical ventricular actuation: a review.
Direct mechanical ventricular actuation (DMVA) is a non-blood contacting method of circulatory support that can be rapidly instituted for resuscitation. DMVA is superior to conventional methods (open and closed-chest cardiac massage) in providing reliable cardiovascular stabilization for resuscitation following cardiac arrest. Furthermore, DMVA has important advantages including rapid application, technical simplicity, and avoidance of blood contact compared to other resuscitation devices (cardiopulmonary bypass and blood pumps). This review summarizes laboratory and clinical applications of DMVA.
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During pilgrimage season (Hajj) in Saudi Arabia 34 patients with heat stroke (HS) were centrally cannulated to assess their state of hydration and fluid requirement during cooling period. Central venous pressure (C. V. ⋯ An average of 1 litre of normal saline or Ringer's lactate (crystalloids) was sufficient to normalize C. V. P. during the cooling period and to restore an optimal state of hydration without predisposing to congestive cardiac failure and pulmonary edema--the potential to develop disastrous adult respiratory distress syndrome and disseminated intravascular coagulopathy.