Duodecim; lääketieteellinen aikakauskirja
-
The Finnish national cardiopulmonary resuscitation guideline has been published as part of the Current Care, evidence-based guidelines series. This article gives a short overview of the main recommendations. Throughout, the guideline emphasises the quality of chest compressions. ⋯ Adrenaline and amiodarone are the only drugs used in cases of cardiac arrest. Patients at risk of cardiac arrest should be identified and preventative action taken. In health care facilities, do-not-attempt-resuscitation (DNAR) decisions should be done in advance for patients who would not survive from cardiac arrest.
-
Non-convulsive status epilepticus is an insidious condition and a challenging diagnosis for neurologists on call. The condition must, however, be recognized, since it constitutes a neurological emergency. Non-convulsive status epilepticus may also be associated as an additional complication with an acute neurologic disease, in which case an EEG recording is usually required. In addition, non-convulsive status epilepticus can be found in a significant proportion of patients with unconsciousness of unknown origin.
-
Cardiac arrest as the first symptom of coronary artery disease is not uncommon. Some of previously healthy people with sudden cardiac arrest may be saved by effective resuscitation and post-resuscitative therapy. The majority of cardiac arrest patients experience the cardiac arrest outside of the hospital, in which case early recognition of lifelessness, commencement of basic life support and entry to professional care without delay are the prerequisites for recovery. After the heart has started beating again, the clinical picture of post-resuscitation syndrome must be recognized and appropriate treatment utilized.
-
The central aim of Current Care Guidelines for resuscitation is to guarantee effective resuscitation for all cardiac arrest patients as carried out by both laymen and professionals. Basic health care training does not guarantee sufficient competence. ⋯ Every health care professional should at least once a year attend the continuing education arranged by persons in charge of resuscitation. New technology will facilitate the reception of feedback from both training sessions and actual resuscitation situations.
-
Calprotectin is a protein released especially from neutrophilic leukocytes and secreted into the intestine during inflammation of the intestinal mucosa. It can be assayed from the feces. Faecal calprotectin has proven to be a useful marker in the diagnostics and monitoring of inflammatory bowel diseases, and application of the assay has been extended from pediatric patients also to adults. Faecal calprotectin is highly elevated in active inflammatory bowel disease, and elevated values in symptomless patients seem to be predictive of exacerbation especially in ulcerative colitis and in Crohn's disease colitis.