Resuscitation
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Comparative Study
Improving the effectiveness of continuous closed chest compressions: an exploratory study.
This study was carried out to establish the length of time over which an individual can maintain effective chest compressions and the most effective pattern of rest and handover among a team. The continuing effectiveness of chest compressions was compared between groups of 2 or 3 rescuers performing chest compressions for 1, 2 or 3 min during scenarios lasting 18 min. Evaluation of the effectiveness of compressions was achieved using a computerised resuscitation manikin (Laerdal/Skillmeter) on a hospital trolley. Twenty-one volunteers competent in basic life support participated. The results were analysed using one-way analysis of variance and Dunnett's contrast of the various scenarios. The results demonstrated that a three person team delivering 1 min periods of chest compressions in rotation is significantly better than other sequences at 5 min and beyond (P<0.0001). At 18 min 91.5% of all chest compressions delivered by this three person team were greater than 70% effective. There was no significant difference between the first and final set of chest compressions. ⋯ Continuous chest compressions performed for 1 min, preferably by three rescuers in rotation, maintain a high level of effectiveness. Longer periods of chest compressions should be discouraged.
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Comparative Study
HBOC-201 improves survival in a swine model of hemorrhagic shock and liver injury.
Blunt abdominal trauma that leads to hemorrhagic shock and cardiac arrest is almost always fatal in the prehospital setting. The current study investigated whether a hemoglobin-based oxygen carrier (HBOC-201) could maintain organ viability during an exsanguinating liver injury and allow for prolonged survival. This hypothesis was tested in a large animal model that simulated blunt abdominal trauma with major organ injury. ⋯ HBOC resuscitation during liver bleeding in a swine model of hemorrhagic shock and liver injury allowed for 96 h survival. No fluid or HES in the same model was fatal.
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Clinical Trial
Prevention of deterioration of ventricular fibrillation by basic life support during out-of-hospital cardiac arrest.
Survival of cardiac arrest is improved by basic life support (BLS). This study investigated the relationship between ventricular fibrillation (VF) characteristics and survival. In a 2-year prospective study out-of-hospital witnessed non-traumatic cardiac arrests were observed. ⋯ Our study demonstrated that BLS and VF as initial rhythm, considered being "baseline" predictors in survival models, were proved not independent of each other. The decrease of VF amplitude and increase in prevalence of asystole is slowed significantly by BLS. Predicting survival from VF amplitude and baseline crossings alone is limited.
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Case Reports
A case of severe hyperkalaemia and compartment syndrome due to rhabdomyolysis after drugs abuse.
Severe hyperkalaemia is one of the complications of the non-traumatic rhabdomyolysis, which have been related to drug abuse, alcohol, etc. We report on a case of bilateral tibial compartment syndrome, severe hyperkalaemia and rhabdomyolysis after drug abuse. A 35-year-old male intravenous drug user was admitted to the emergency department after being found unconscious in his cell of the prison. ⋯ Rhabdomyolysis has been reported after drug abuse. There is severe hyperkalaemia which should be identified and treated. A more rare complication of rhabdomyolysis is the compartment syndrome, a surgical emergency, which requires immediate fasciotomy to prevent serious complications.