Resuscitation
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Cardiopulmonary resuscitation by manual cardiac compression can restore cardiocirculatory function but can also injure patients. Commonly reported are skeletal fractures of the rips and sternum, while injuries to the large thoracic vessels will frequently be lethal. ⋯ Stenotic segments of coronary arteries were treated successfully by implantation of three drug-eluting stents followed by dual antiplatelet therapy. The patients recovered almost completely and was discharged for further rehabilitation after 3 weeks.
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The objective of this study was to identify prognostic predictors for the patients experiencing cardiogenic shock who required the institution of intra-aortic balloon counterpulsation (IABP). ⋯ This study has illustrated that age, renal function, and etiology-related cardiac injury are predictors for in-hospital course and mortality in those who experienced cardiogenic shock with IABP. The optimal strategy for revascularization in this high-risk group needs further validation.
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In the newborn infant, accurate endotracheal tube (ETT) placement is essential for adequate ventilation and surfactant delivery. This study aimed to determine the relationship between gestation, weight and endotracheal tube length, and to evaluate the promotion of gestation-based guidelines for ETT length. ⋯ Use of gestation-based guidelines on ETT length for neonatal intubation was associated with a reduction in tube malposition and uneven lung expansion. A table of ETT length against gestation and weight is provided to assist those carrying out this procedure, which could be incorporated into neonatal resuscitation training.
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The earliest initiation of mild hypothermia after resuscitation from cardiac arrest is crucial. This study aimed to evaluate the feasibility and safety of out-of-hospital surface cooling in such cases. ⋯ Non-invasive surface cooling immediately after resuscitation from cardiac arrest, in the out-of-hospital setting, proved to be feasible, fast and safe. Whether early cooling will improve neurological outcome needs to be determined in future studies.
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Early recognition and treatment of hemorrhagic shock after trauma limits multi-organ failure and mortality. Traditional vital signs (VS) although specific are not highly sensitive for hemorrhage detection. Metabolic parameters such as lactate and base deficit (BD) are highly sensitive indicators of blood loss by measuring tissue perfusion. Does adding information from BD and lactate to traditional VS improve the identification of trauma patients with major injuries? ⋯ The addition of BD and lactate to triage vital signs increases the ability to distinguish major from minor injury.