Scand J Trauma Resus
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CPR has a proven role in improving survival in cardiac arrest victims, especially those who are outside the hospital. Guidelines published by the AHA have included CPR as a vital intervention for decades. The previous guidelines have focused on the maintenance of airway as the first step, there by delaying the provision of chest compressions. However, the 2010 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care corrects this by changing the A-B-C of CPR to C-A-B, acknowledging that chest compressions are the most important aspect of the cardiac arrest management.
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Scand J Trauma Resus · Jan 2010
Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria.
Incidence of Blunt Cerebrovascular Injuries (BCVI) after head injury has been reported as 0.5-1% of all admissions for blunt trauma, with a high stroke and mortality rate. The purpose of this study is to evaluate if a modification of Memphis criteria could improve the rate of BCVI diagnosis. ⋯ A modification of a single criteria of Memphis screening protocol might permit the identification of a higher percentage of BCVI. Limited by sample size, this study needs to be validated.
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Scand J Trauma Resus · Jan 2010
Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock: A preclinical observational model.
Clot strength by Thrombelastography (TEG) is associated with mortality during trauma and has been linked to severity of tissue hypoperfusion. However, the optimal method for monitoring this important relationship remains undefined. We hypothesize that oxygen transport measurements will be associated with clot strength during traumatic shock, and test this hypothesis using a swine model of controlled traumatic shock. ⋯ Among multiple measurements of oxygen transport, only ScvO₂ was found to retain a significant association with TEG-MA during shock after adjusting for multiple covariates. ScvO₂ should be further studied for its utility as a clinical marker of both tissue hypoxia and clot formation during traumatic shock.
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Scand J Trauma Resus · Jan 2010
Risk assessment of pre-hospital trauma airway management by anaesthesiologists using the predictive Bayesian approach.
Endotracheal intubation (ETI) has been considered an essential part of pre-hospital advanced life support. Pre-hospital ETI, however, is a complex intervention also for airway specialist like anaesthesiologists working as pre-hospital emergency physicians. We therefore wanted to investigate the quality of pre-hospital airway management by anaesthesiologists in severely traumatised patients and identify possible areas for improvement. ⋯ Our risk assessment indicated a high probability for trauma patients with an indication for pre-hospital ETI not receiving it in the studied HEMS. The uncertainty factors identified in the assessment should be further investigated to better understand the problem assessed and consequences for the patients. Better quality of pre-hospital airway management data could contribute to a reduction of these uncertainties.
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Scand J Trauma Resus · Jan 2010
Comparative StudyCuff overinflation and endotracheal tube obstruction: case report and experimental study.
Initiated by a clinical case of critical endotracheal tube (ETT) obstruction, we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. ⋯ We could not demonstrate a critical obstruction of an ETT by its inflated cuff, neither when the cuff was over-inflated to a pressure of 12 kPa or higher, nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress.