Resuscitation
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The text book of Pediatric Advanced Life Support of the American Heart Association recommends that a reservoir is used with a self inflating bag valve device. The figure in the book suggests that if such a device is connected to an oxygen supply, the oxygen will fill the bag first and then go on to fill the reservoir. However the valve structure of the self-inflating device does not permit active entry of oxygen into the bag, unless the bag is deflated and allowed to reinflate, drawing oxygen from the reservoir. ⋯ Eighty percent oxygen was achieved after eight reinflation cycles. We developed a formula to calculate the concentration of oxygen in the bag after each inflation effort, assuming that there was no passive diffusion of oxygen. We suggest that compressing the bag 8-12 times prior to putting the mask to the face of the patient will allow 80% oxygen to be delivered with first breath.
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Although life threatening emergencies in dental practice are not frequent, dentists have to be competent in providing basic life support (BLS). ⋯ The poor overall results, although similar to those shown in the literature, have made us question the validity of our methods of teaching BLS. We were able to establish a correlation between demographic and sociocultural variables with the typical errors, and to begin the process of improving our teaching methods.
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Safety and effectiveness are the goals in treating patients with arrhythmias. In an open prospective study, we observed the efficacy and safety of up to 2 mg intravenous ibutilide, a new class III antiarrhythmic agent in haemodynamically stable patients presenting in the emergency department (ED) with symptoms of recent-onset (<48 h) atrial fibrillation/flutter. Arrhythmia termination within 90 min, haemodynamic parameters and proarrhythmic effects were assessed. ⋯ Forty-seven patients (92%) were discharged within a median of 9 h and managed as outpatients. In conclusion, in haemodynamically stable patients with recent-onset atrial fibrillation/flutter intravenous ibutilide and external electrical cardioversion for conversion to sinus rhythm turned out to be effective and safe. The short duration of admission makes this strategy attractive for use in the ED.
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Biography Historical Article
The resuscitation greats. Friedrich Trendelenburg (1844-1924).