Critical care : the official journal of the Critical Care Forum
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The usefulness of basic cardiopulmonary resuscitation (CPR) training in school systems has been questioned, considering that young students may not have the physical or cognitive skills required to perform complex tasks correctly. In the study conducted by Fleishhackl and coworkers, students as young as 9 years were able to successfully and effectively learn basic CPR skills, including automated external defibrillator deployment, correct recovery position, and emergency calling. As in adults, physical strength may limit the depth of chest compressions and ventilation volumes given by younger individuals with low body mass index; however, skill retention is good. ⋯ Training captured audiences of trainees, such as the entire work-force of the community or the local school system, are excellent mechanisms to help achieve that goal. In addition to better retention with new half hour training kits, a multiplier effect can be achieved through school children. In addition, early training not only sets the stage for subsequent training and better retention, but it also reinforces the concept of a social obligation to help others.
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Mortality of severe acute respiratory distress syndrome in adults is still unacceptably high. Extracorporeal membrane oxygenation (ECMO) could represent an important treatment option, if complications were reduced by new technical developments. ⋯ Veno-venous extracorporeal membrane oxygenation with a new miniaturized device supports gas transfer effectively, allows for highly protective ventilation and is very reliable. Modern ECMO technology extends treatment opportunities in severe lung failure.
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Renal replacement therapy (RRT) is a fully established treatment for critically ill patients with acute kidney injury (AKI) but there are no scientifically established criteria when to initiate it. Our objectives were to describe the epidemiology of critically ill patients with AKI receiving RRT and to evaluate the relationship between biochemical, physiological and comorbid factors at time of RRT and ICU mortality. ⋯ Oligoanuria, acidosis and concomitant dysfunction of other organs at time of RRT were associated with poor survival. In contrast, serum creatinine and urea levels only had a weak correlation with outcome after RRT.
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Medical Emergency Teams (METs), also known as Rapid Response Teams, are recommended as a patient safety measure. A potential benefit of implementing an MET is the capacity to systematically assess preventable adverse events, which are defined as poor outcomes caused by errors or system design flaws. We describe how we used MET calls to systematically identify preventable adverse events in an academic tertiary care hospital, and describe our surveillance results. ⋯ Our method of reviewing MET calls was easy to implement and yielded important results. Hospitals maintaining an MET can use our method as a preventable adverse event detection system at little additional cost.
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The effect of sepsis on epidermal wound healing has not been previously studied. It was hypothesised that epidermal wound healing is disturbed in severe sepsis. ⋯ The restoration of the epidermal barrier function is delayed and wound blood flow is increased in patients with severe sepsis.