Resuscitation
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Comparative Study
Early immunologic responses to trauma in the emergency department patients with major injuries.
A traumatic insult initiates an inflammatory cascade, which is a contributor to cell damage and could be a marker of injury severity. ⋯ We found evidence of a measurable early inflammatory response to trauma, using cytokine levels and lymphocyte subset counts.
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We report the successful use of the Proseal laryngeal mask airway as a rescue device in three pre-hospital cases where tracheal intubation after induction of anaesthesia had failed. The ProSeal LMA allowed ventilation and oxygenation of all three patients under difficult circumstances.
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Taiwan is a small island country located in East Asia. From around 1995 modern concepts of the EMS were imported and supported by legislation. Considerable progress has since been made towards the construction of an effective pre-hospital care system. ⋯ The features and problems of in-hospital emergency care are also discussed. Key areas for further development in the country vary depending on regional differences in available resource and population density. An analysis of the strength, weakness, opportunity, and threats of the evolving EMS in Taiwan could be an example for other countries where the EMS is undergoing a similar process of development and optimisation.
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Randomized Controlled Trial
Reduced hands-off-time and time to first shock in CPR according to the ERC Guidelines 2005.
Chest compressions and early defibrillation are crucial in cardiopulmonary resuscitation (CPR). The Guidelines 2005 brought major changes to the basic life support and automated external defibrillator (BLS-AED) algorithm. We compared the European Resuscitation Council's Guidelines 2000 (group '00) and 2005 (group '05) on hands-off-time (HOT) and time to first shock (TTFS) in an experimental model. ⋯ In this manikin setting, HOT and TTFS improved with BLS-AED performed according to Guidelines 2005.
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Multicenter Study Comparative Study
Analysis of medical emergency team calls comparing subjective to "objective" call criteria.
To explore the reasons why nursing staff use the subjective "worried" Medical Emergency Team (MET) calling criterion and compare the outcomes of calls activated using the "worried" criterion with those calls activated using "objective" criteria such as vital sign abnormalities. ⋯ The "worried" criterion was the most frequent reason for MET calls, implying a high degree of empowerment and independent action by nursing staff. Low SpO2 and respiratory distress were the most common causes for concern. There was a significant difference between MET calls triggered by "worried" criteria and "objective" criteria for outcomes immediately following MET (p < 0.001). Further assessment and refinement of MET triggers particularly in relation to respiratory distress and pulse oximetry may be needed.