Crit Care Resusc
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Out-of-hospital cardiac arrest (OHCA) is a significant cause of death, but there is little published information on its incidence and outcomes in Australia. ⋯ Survival from OHCA in Sydney is low, and lower in patients aged 80 years or older. The incidence of OHCA in Sydney is similar to that in the rest of the world. Mortality occurs early after OHCA. Hence, for interventions to be effective in improving survival, they need to be targeted at the early stages of OHCA.
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Biography Historical Article
Notable Australian contributions to the management of ventilatory failure of acute poliomyelitis: with special reference to the Both respirator and Dr. John A. Forbes.
When Australia's 1937 epidemic of poliomyelitis created an urgent need for extra ventilating machines to compensate for respiratory paralysis, Edward Both, an innovative Adelaide biomedical engineer, invented a wooden-cabinet respirator capable of being made relatively quickly in sufficient quantity. His device, here called "the Both", alleviated the problem at Adelaide's Northfield Infectious Diseases Hospital and others, and in late 1938 was introduced into England when Both was visiting there. Appreciating its merits, Lord Nuffield financed assembly-line production at the Morris motor works in Cowley, Oxford. ⋯ Dr John Forbes at Fairfield became the foremost Australian clinician for expertise with the Both. Before the advent of intermittent positive pressure ventilation, the Both's usefulness had seen it tried for ventilatory failure in some non-polio conditions, but uptake of that application was limited. Nonetheless, Nuffield's philanthropy with the (Nuffield-)Both ultimately furthered progress along the 20th century pathway to intensive care medicine.
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To generate baseline data describing Australasian intra-aortic balloon counterpulsation (IABP) weaning practice. ⋯ The Australasian approach to IABP weaning is eclectic. While ratio reduction weaning appears the most successful manner of support withdrawal, it may be a consequence of a volume-outcome relationship, with high- end users achieving better results through IABP familiarity.
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Flail chest after blunt trauma usually requires good pain control and positive pressure support. Continuous negative extrathoracic pressure (CNEP) causes a splinting effect around the anterior chest wall and upper abdomen which increases functional residual capacity and improves lung mechanics. ⋯ She was subsequently ventilated non-invasively using CNEP, allowing early successful extubation. This case illustrates the use of CNEP for weaning and ventilating patients with flail chest after blunt trauma.