Resuscitation
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Comment Letter
Improving ROSC with high dose of epinephrine. Are we really?
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Hemorrhagic shock is a pathologic state in which intravascular volume and tissue oxygen delivery are impaired, leading to circulatory collapse and cellular ischemia. Resuscitation with hemoglobin-based oxygen carriers (HBOCs) is appealing in that their use can both restore intravascular volume and tissue oxygenation, without the limitations in supply and immunomodulatory effects of packed red blood cells. ⋯ We then review the history of early HBOC development and the modern understanding of their mechanisms of toxicity, which has informed the rational design of second-generation agents. Finally, we provide an overview of these second-generation HBOCs that are under active investigation or have recently completed phase 3 clinical trials.
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A simulation program was implemented in a pre-registration nursing curriculum for developing nursing students' performances in assessing, managing and reporting in relation to patients with physiological deterioration. ⋯ The findings provide an understanding of how a simulation program may impact on the nursing students' performances in clinical practice, which is useful information for future improvement of programmes to optimize learning and transfer effective care to patient care settings.