European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Serious pulmonary and cardiac failure may be treated with extracorporeal membrane oxygenation (ECMO) when the conventional treatment fails. Improvements in extracorporeal circulation devices have allowed us to set up two specialized mobile units: a mobile cardiac assistance unit (MCAU) and a mobile respiratory assistance unit (MRAU). Their role is to provide ECMO at patient's bedside, and then to ensure inter-hospital transport (IHT). The aim of this study was to evaluate our experiences with the transportation of patients on ECMO. ⋯ This study shows that mobile ECMO system can be successfully and quickly established at patient's bedside, and that transportation of patients on ECMO can be performed safely and without technical difficulties.
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As a result of national guidance in the UK, the number of computed tomography brains performed in patients with minor head injury has increased significantly. The aim of this survey was to establish the requirement for general anaesthesia and tracheal intubation in the management of emergency department patients requiring an urgent computed tomography of the brain. About 300 consecutive scans in emergency department patients were reviewed. The majority (>90%) did not require anaesthetic airway management despite an overall acute scan diagnosis rate of around 25% and 30 day mortality of 10%.
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Comparative Study
A comparison of autopsy detected injuries in a porcine model of cardiac arrest treated with either manual or mechanical chest compressions.
The objective of this study was to evaluate and compare the complications of cardiopulmonary resuscitation after manual or mechanical chest compressions in a swine model of ventricular fibrillation. In this retrospective study, 106 swine were treated with either manual (n=53) or mechanical chest compressions with the LUCAS device (n=53). All swine cadavers underwent necropsy. ⋯ Nine animals in the manual, and two in the LUCAS group had liver hematomas (P=0.026%). In the manual group, eight animals were detected with spleen hematomas whereas no such injury was identified in the LUCAS group (P=0.003). LUCAS devise minimized the resuscitation-related trauma compared with manual chest compressions in a swine model of cardiac arrest.