Resuscitation
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To discover design principles underlying the optimal waveforms for external chest and abdominal compression and decompression during cardiac arrest and cardiopulmonary resuscitation (CPR). ⋯ Optimized waveforms for thoraco-abdominal compression and decompression include previously discovered features of active decompression and interposed abdominal compression. These waveforms can be used by manual (Lifestick-like) and mechanical (vest-like) devices to achieve short periods of near normal blood perfusion non-invasively during cardiac arrest.
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Review Historical Article
Prehospital management of sarin nerve gas terrorism in urban settings: 10 years of progress after the Tokyo subway sarin attack.
Chemical agents have been used previously in wartime on numerous occasions, from World War I to the Gulf War. In 1994 and 1995, sarin nerve gas was used first in peacetime as a weapon of terrorism in Japan. The Tokyo subway sarin attack was the first large-scale disaster caused by nerve gas. ⋯ All of these therapies may be given simultaneously. This article reviews toxicology and management of this acute chemical emergency. To help minimize the possible catastrophic impact on the public, we make several recommendations based on analysis of the Tokyo subway sarin attack and systematically review the current scientific literature.
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The success rate of cardiopulmonary resuscitation (CPR) may differ from institution to institution, even within different sites in the same institution. A variety of factors may influence the outcome. In this study, we assessed the adequacy of CPR attempts guided by the current standards and aimed to define the factors influencing the outcome following in-hospital cardiac arrest. ⋯ Our rates of immediate survival, survival at 24 h and survival to discharge 49.3%, 28.5% and 13.4%, respectively. The extent of monitoring prior to arrest, the attendance of one or more experienced anesthesiologists in the CPR team, CPR during office hours, CPR in ICU or operating room, early initiation of CPR and tracheal intubation prior to arrest were found as the factors increasing discharge survival. We conclude that early initiation of CPR with an experienced team in a well-equipped hospital sites increases the discharge survival rate following cardiac arrest.
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Biography Historical Article
The resuscitation greats. Cemil Topuzlu Pasha: one of the forgotten pioneers in the history of open chest cardiac massage.
One of the pioneers of open chest cardiac massage was Cemil Topuzlu Pasha, in Turkey. He presented his experience in open heart cardiac massage in several papers published in Ottoman and French and German. ⋯ Meanwhile he had defined "Do Not Resuscitate" code in cases involving serious heart disease and other diseases where life expectancy is very short. The Ottoman version of his report is translated in this paper.
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The Resuscitation Council (UK) Advanced Life Support (ALS) Course is a multidisciplinary training course which teaches participants how to manage the resuscitation of a patient at risk of or in cardiac arrest. To reduce variability in assessments, four standardised patient scenarios have been developed with common performance criteria. The aim of the study was to establish how much candidates remembered about their test in order to assess the potential for collusion. ⋯ However, even in this group, the overall recall of all elements of the scenario was correct in only 49% of instances. This study demonstrated that immediately after testing candidates had good recall of the initial clinical scenario with which they were presented, but poor recall of cardiac arrest rhythms during the simulated resuscitation attempt. These findings provide some reassurance that the likelihood of successful collusion improving subsequent candidates performance is likely to be small as recall of the scenario progression is limited.