Resuscitation
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To measure an appropriately sized nasopharyngeal airway, it is taught that the size is related to the patients little finger or nostril (anterior nares). This study has been designed to identify whether these comparisons are valid. ⋯ The methods used traditionally to size a nasopharyngeal airway do not correlate with the airway anatomy and are unreliable. It is more appropriate to size the airway dependent upon the patient's size, sex and race.
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To investigate the response to cardiac arrest in general wards. ⋯ The majority of the cardiac arrest teams have acceptable response times, but their efficiency may be impaired by the lack of staff, equipment and co-ordination with the ward personnel. CAT members identified a strong need for BLS training of ward personnel. More widespread introduction of standard protocols for resuscitation and reporting of cardiac arrest are necessary to evaluate aspects that may need improvement.
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Non-traditional and lay first responders increasingly are being trained in the skill of defibrillation. With simplification of new devices, there is a need to determine optimal first responder selection and training and maintenance of this important skill. These issues are of prime importance for the St John Ambulance Australia Operations Branch which already has a substantial first response defibrillation programme. ⋯ For St John first responders proficient in cardiopulmonary resuscitation (CPR), the skill of defibrillation with an AED is readily acquired and maintained. While less experienced members may be less likely to acquire the skill initially, once acquired the skill is equally maintained by all, provided ongoing 'on duty' exposure is available.
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Successful defibrillation is dependent upon the delivery of adequate electrical current to the myocardium. One of the major determinant of current flow is transthoracic impedance. Prior work has suggested that impedance falls with repeated shocks during sinus rhythm. The purpose of this study was to evaluate changes in transthoracic impedance with repeated defibrillation shocks in an animal model of cardiac arrest due to ventricular fibrillation (VF). ⋯ Transthoracic impedance does not change significantly with repeated shocks in a VF cardiac arrest model. This is likely due to the lack of reactive skin and soft tissue hyperemia and edema observed in non-arrest models.
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Biography Historical Article
The Resuscitation Greats: Andreas Vesalius, the concept of an artificial airway.