Resuscitation
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The quality of life support delivered during cardiopulmonary resuscitation affects outcomes. However, little data exist regarding the quality of resuscitation delivered to children and factors associated with adherence to American Heart Association (AHA) resuscitation guidelines. ⋯ Pediatric residents do not meet performance standards set by the AHA. Future curricula should focus training on identified defects including: (1) equal emphasis on "airway and breathing" and "circulation" and (2) hands-on training with using and discharging a defibrillator in order to improve safety and outcomes.
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Case Reports
Electrical injury during "hands on" defibrillation-A potential risk of internal cardioverter defibrillators?
Despite clear guidance for the need for rescuers to avoid contact with a patient during external defibrillation, the advice regarding the potential dangers of rescuer contact during the firing of an internal cardioverter defibrillator [ICD] generally implies that such contact is safe. This case report describes documented nerve injury to a rescuer by a shock delivered from an ICD during chest compression on a patient in cardiac arrest. The authors also discuss the existing literature on the subject and make suggestions for future management.
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To test the hypothesis that a fractional inspired oxygen (F(I)O(2)) of 1.0 compared to 0.4 during hemorrhagic shock (HS) and fluid resuscitation (FR): mitigates tissue dysoxia; however, enhances the oxidative stress; therefore, offsets the benefit on survival. ⋯ Supplemental oxygen does not mitigate tissue dysoxia during HS, but does reduce tissue dysoxia without enhancing oxidative stress during subsequent FR. Increased F(I)O(2) appears to prolong survival. These beneficial effects of supplemental oxygen do not differ between an F(I)O(2) of 0.4 and 1.0.
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The Emergency Medical Services (EMS) in Oman is a relatively new project in the country. It has been developed based on the Anglo-American system of EMS. Currently, it is run by trained Omani Advanced Emergency Medical Technicians (AEMT) under the auspices of the Royal Oman Police (ROP) Ambulance Division. ⋯ It is state-funded and free of charge for all people in Oman. There are plans to incorporate aero-medical services into the system, to support the land ambulance service, and there are also plans to expand its coverage to the whole country by 2012. The EMS in Oman has hard challenges ahead but there are also promising plans in place to improve the system.