Postgraduate medicine
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Postgraduate medicine · Feb 1987
Headache caused by serious illness. Evaluation in an emergency setting.
Severe headache is a common problem among patients in the emergency facility. Because early therapy reduces deaths from subarachnoid hemorrhage, the physician must use advanced technological and sometimes invasive tests to diagnose this serious condition in patients with equivocal signs and symptoms. In patients with meningitis, the physician must assume there will be only one opportunity to make the correct diagnosis. Because patients often seek emergency care early in the course of meningitis, when accurate detection on clinical grounds is more difficult, a conservative approach and liberal use of all appropriate diagnostic techniques are essential.
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Postgraduate medicine · Feb 1987
Historical ArticleCardiopulmonary resuscitation. Historical and future perspectives.
Although cardiopulmonary resuscitation (CPR) has been practiced for over a century, further study into methods for reviving victims of cardiac arrest is obviously needed. We now know that standard external CPR has numerous drawbacks, and modifications must be tested in a careful, randomized fashion. Three alternatives to standard external CPR (simultaneous compression-ventilation, interposed abdominal compression, and open-chest CPR) are currently being investigated. ⋯ Research must continue into ways of providing rapid advanced cardiac care, such as home defibrillators or rapid prehospital response to the victims of cardiac arrest by those trained in advanced cardiac life support (ACLS). In addition, to counteract the problem of neurologic demise after prolonged anoxia, study of postresuscitative care must continue. Only through the combination of these measures will survival rates after cardiac arrest improve.