Resuscitation
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This study analyses, retrospectively, an established data set to measure the effect of the circulation change in European Resuscitation Council Guidelines. This prospective matched control study examined the extent to which Year 6 (10-11 years) children retained and were able to demonstrate the sequencing and assessment skills of Basic Life Support (BLS) techniques 5 months after BLS training through the Injury Minimization Programme for Schools (I. M. ⋯ With strict adherence to Resuscitation Council guidelines, 'optimal' life saving procedures (all primary BLS steps performed optimally), were initiated by very few, marginally better in the intervention than the control group, intervention 6 (1.1%) controls 0 (0%). Some children in both groups performed the cardio-pulmonary resuscitation (CPR) element of BLS in an ineffective manner. Changing the circulation assessment would seem appropriate and allow recognition of life support attempts that are beneficial if not optimal.
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Previous studies indicate that Norwegian physicians hold conservative attitudes towards ethically controversial end-of-life decisions. The present study was undertaken to explore whether in Norway euthanasia may be hidden under labels such as death after analgesic injections and withholding or withdrawing treatment. ⋯ Only a small minority of Norwegian physicians has committed euthanasia. However, patient death has occurred following ethically questionable decisions such as withdrawal of treatment based on resource considerations and requests from the family.
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Previous studies suggest glucose, insulin and potassium (GIK) infusion during ischemia reduces infarct size and improves post-ischemic myocardial function in acute myocardial infarction and following surgical revascularization of the heart. The potential use of GIK when given only during reperfusion after a period of global ischemia, as might occur during cardiac arrest, is unclear. To test the hypothesis that GIK reperfusion improves post-ischemic myocardial bioenergetics and function, we utilized a perfused heart model. ⋯ Hearts reperfused with GIK had significantly higher developed pressure and higher dP/dt than control reperfused hearts. Reperfusion with GIK improved post-ischemic recovery of both contractile function and the myocardial bioenergetic state. GIK may be a viable adjunctive reperfusion therapy following the global ischemia of cardiac arrest to improve post-resuscitation cardiac dysfunction.
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Biography Historical Article
William O'Shaughnessy, Thomas Latta and the origins of intravenous saline.