Resuscitation
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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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Biography Historical Article
Resuscitation great. George W. Crile: a visionary mind in resuscitation.
George Washington Crile was a successful surgeon who lived at the end of the 19th century. He was born on 11 November 1864 on a farm near Chili, Ohio. He became interested in the study of shock after a close friend died from hemorrhage. ⋯ Having written over 400 papers and 24 books, George W. Crile died from complications of bacterial endocarditis on 7th January 1943. Although they were published a long time ago, his contributions to medicine remain fundamental to clinical practice in today's operating rooms and critical care units.
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Approximately 750,000 in-hospital cardiac arrests occur annually in the United States. Many will occur to visitors or staff members within the hospital's public areas. We sought to provide a descriptive analysis of visitor cardiac arrests in hospitals and to compare survival outcomes to matching inpatient arrests. ⋯ Cardiac arrest among hospital visitors is a relatively common event. The survival outcomes of hospital visitors compared unfavorably to that of recently published experience with out-of-hospital cardiac arrest victims.
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High oxygen increases morbidity and mortality. Current guidelines in Neonatal Resuscitation Programme (NRP) state if self-inflating bags are used with an input FiO2 of 1.0 without an oxygen reservoir a delivered safe FiO2 of approximately 0.40 is achieved. This conflicts with manufacturer findings (Laerdal infant resuscitator (LIR)). We assessed FiO2 delivery by the LIR, varying oxygen reservoir (OR) use, ventilation and input flowrates. ⋯ Our findings support the manufacturers performance specification that high input FiO2 results in high delivered FiO2 with/without an OR. These results dispute the 2006 NRP guidelines that state "in the absence of a reservoir (oxygen) the delivered oxygen is reduced to about 40%".
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To objectively evaluate how effectively children can perform cardiopulmonary resuscitation CPR) 2 months after a single, 2h training session and establish whether or not their performance is affected by the ratio of external chest compressions to ventilations used. ⋯ Children as young as 10-11 years are capable of performing effective CPR after a single, 2h training session in cardiopulmonary resuscitation given in school. This age group are able to achieve greater depth of chest compressions, when using a ratio of 15:2 rather than 30:2.