Resuscitation
-
Historical Article
Resuscitation great. A history of mechanical devices for providing external chest compressions.
The importance of providing good quality chest compressions with limited interruptions has been emphasised by the Resuscitation Guidelines 2005. The difficulties of providing consistent, good quality, chest compressions manually are well documented and attempts have been made to devise mechanical means to achieve this. ⋯ This paper provides a brief historical review of some of the mechanical devices which have been invented over the last 45 years in order to deliver external chest compressions. It also suggests some reasons why these devices failed to become a regular part of resuscitation practice.
-
Review Case Reports
Out-of-hospital cardiac arrest from air embolism during sexual intercourse: case report and review of the literature.
We report the successful resuscitation of a 38-year-old woman in cardiac arrest following heterosexual intercourse 7 days after spontaneous abortion and an instrumental uterine evacuation. The collapse was thought to be due to venous air embolism (VAE). Her survival neurologically intact was attributed to appropriate first aid, pre-hospital and subsequent hospital intensive care. ⋯ Diagnostics and management techniques for venous air embolism are discussed. Air embolism should be included in the differential diagnosis for all young women in cardiac arrest, particularly when occurring during sexual activity. Instructions in risks of sexual intercourse during pregnancy and the puerperium should become part of pregnant women's education.
-
Recent studies document a high incidence of hyperventilation by prehospital providers, with a potentially detrimental effect on outcome in traumatic brain injury (TBI). ⋯ The incidence of hyperventilation by aeromedical crews was lower than reported for ground paramedics and appears to occur in response to desaturation, impending hypoxemia, or loss of SpO2 signal.
-
Ireland introduced paramedic services to its ambulance services in 2005 and an accredited training programme has begun to train candidates. The training programme is 11 months long and includes distance learning, taught and internship phases. The internship involves six weeks of supervised paramedic practice in the setting of a rapid response vehicle crewed by two candidates, principally in urban and suburban settings. Internationally, little information has been published on the educational opportunities or impact of paramedic training and particularly on the clinical practice components of that training. ⋯ Well supervised clinical training facilitates the transition from student to autonomous practitioner. Candidates in this programme accomplished a range of clinical assessments, decisions and interventions with the support of a senior supervisor, but in a situation where they carried responsibility for safe practice.
-
Perceived self-efficacy is a predictor of behaviour and therefore an important dimension of resuscitation training which may have consequences for patient care. The Advanced Paediatric Life Support (APLS) course makes use of techniques which would be expected to increase self-efficacy. We examined the effect of this course on perceived self-efficacy in respect of resuscitation skills and on the use of these skills. ⋯ The APLS course does have an important effect on perceived self-efficacy but this is not related to an increase in the frequency of use of the skills learned on the course, partly because the opportunity for increased use is lacking. Further work is needed to determine whether the quality of those skills is improved by the course.