Medicina
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Comparative Study
[The assessment of clinical evaluation and treatment results of high-energy blunt polytrauma patients].
The aim of this study was to evaluate the mechanism of high-energy blunt trauma, age and gender of patients, severity of regional and multiple injury, ventilation time, length of stay in intensive care unit and in-hospital stay, in-hospital complications, and treatment outcome. ⋯ Working-age male pedestrians (17-64 years old) made up two-thirds of all polytrauma patients. Severe injuries of extremities, head, and chest were present in 69.1% of all cases. Lung complications were the most common.
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Various drugs can be associated with QT prolongation. A prolonged QT interval leads to an increased risk for the development of ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia (torsades de pointes). ⋯ Torsades de pointes is classically associated with early depolarization. This review article discusses the mechanisms of QTc prolongation and triggering factors for proarrhythmia, drugs that prolong QT interval (class III antiarrhythmic agents, antimicrobial agents - fluoroquinolone and macrolide antibiotics, antipsychotic and antidepressant drugs, agents used in general anesthesia, antimycotics, and several other drugs), nonpharmacological and pharmacological risk factors for arrhythmias (due to pharmacokinetic-pharmacodynamic interactions), the treatment and recommendations to prevent arrhythmia related to QT prolongation.
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Five years after the last issue of the guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, in 2005 American Heart Association and European Resuscitation Council published new guidelines. In this review, basic life support (BLS) technique, indications for use of an automated external defibrillator (AED), recognition of sudden cardiac arrest, and management of choking (foreign-body airway obstruction) are presented according to the "Resuscitation Guidelines 2005."
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Acute right ventricular failure is a syndrome, which is related to pulmonary and right heart dysfunction. It may occur with or without cardiopulmonary pathologies. It is often life threatening and requires early recognition and urgent treatment. In this review article, precipitating factors for right ventricular failure and its pathophysiological mechanisms, clinical picture and hemodynamic manifestations, the principles of the management of acute right ventricular failure (optimization of preload, increase in cardiac output, specific pulmonary vascular vasodilators, problems of mechanical ventilations, etc.) are discussed.
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Comparative Study
The ability of Lithuanian ambulance services to provide first medical aid in trauma cases.
To evaluate the ability of country ambulance services to provide first medical aid in trauma cases. ⋯ Country ambulance service network configuration according to area under service, number of people served, and response frequency comply with the requirement set. The ambulance vehicles lack complete set up as well as some important supplies. Only rarely the staff is skilled enough to perform such advanced life support procedures as intubation, defibrillation, and pleural drainage.