Resuscitation
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Pulseless electrical activity is an important cause of cardiac arrest. Our purpose was to determine if induction of hypothermia with a cold perfluorocarbon-based total liquid ventilation (TLV) system would improve resuscitation success in a swine model of asphyxial cardiac arrest/PEA. ⋯ Induction of moderate hypothermia using perfluorocarbon-based total liquid ventilation did not improve ROSC success in this model of asphyxial cardiac arrest.
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To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning. ⋯ Predictive pre-resuscitation factors may supplement patient-specific information available at bedside to assist in revising resuscitation plans during the patient's hospitalization.
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Endotracheal intubation (ETI) is considered to be the gold standard of prehospital airway management. However, ETI requires substantial technical skills and ongoing experience. Because failed prehospital ETI is common and associated with a higher mortality, reliable airway devices are needed to be used by rescuers less experienced in ETI. We prospectively evaluated the feasibility of laryngeal tubes used by paramedics and emergency physicians for out-of-hospital airway management. ⋯ The LT-D/LTS-D represents a reliable tool for prehospital airway management in the hands of both paramedics and emergency physicians. It can be used as an initial tool to secure the airway until ETI is prepared, as a definitive airway by rescuers less experienced with ETI or as a rescue device when ETI has failed.
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Biography Historical Article
Dominique-Jean Larrey: the effects of therapeutic hypothermia and the first ambulance.
The fields of emergency medicine and resuscitation are indebted to the Baron Dominique-Jean Larrey (1766-1842) for significant advances in patient care. Larrey was a great surgeon who served in the French army during Napoleon's rule. ⋯ Larrey coined the term "Triage" to allocate resources to those most in need of emergent care. Today, many of his techniques still prevail in modern medicine.
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This observational study aims to describe: (1) the use of positive pressure ventilation (PPV) for resuscitation in the delivery room among newly born near-term infants; (2) the methods used for PPV resuscitation [e.g., bag-facial mask (BFM), laryngeal mask airway (LMA), endotracheal tube (ETT)]; and (3) the association of each device with short-term neonatal outcomes. ⋯ The LMA is an effective device for primary airway management of near-term infants and for secondary airway management among near-term infants failing BFM or ETT resuscitation.