Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Quality assurance is a managerial responsibility, but the medical management itself must also be quality assured. Today quality assurance of medical management is usually performed when the organization is not functioning properly, but quality assurance should be a continuous process. ⋯ The medical profession must start this work now. There are many others who want to take it over.
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Tidsskr. Nor. Laegeforen. · Sep 1992
Case Reports[Embolization of bronchial arteries in severe and recurrent hemoptysis].
Bronchial artery embolization is an established treatment for massive and serious haemoptysis. We review etiology, pathogenesis and different treatment modalities of major haemoptysis, and discuss indications and outcome. Massive haemoptysis, defined as > 300 ml/24 hrs., is a rare condition with a high mortality rate (30-80%) if treated conservatively. ⋯ In patients with severely reduced lung function and progressive disease, recurrent haemoptysis of even smaller amounts might interfere with postural drainage and cause infections and deteriorate lung function. Bronchial artery embolization should be considered for these patients as well. Unless localized lesions can be cured through surgical resection, we consider bronchial artery embolization to be the treatment of choice.
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Tidsskr. Nor. Laegeforen. · Sep 1992
[Cardiopulmonary resuscitation performed by laymen--the Nord-Gudbrandsdal Project--circulatory arrest in sparsely populated regions].
Previous investigations from densely populated areas have shown that more patients with prehospital circulatory arrest caused by ischemic heart disease can be successfully treated by strengthening a chain of survival. This chain consists of immediate alarm followed by prompt cardiopulmonary resuscitation, early defibrillation and advanced medical support before transportation to hospital. This paper describes the methods used in the training of lay people in cardiopulmonary resuscitation, as well as how ambulance personnel were trained to use a semiautomatic defibrillator. During the period 1987-89 11.7% of the inhabitants in Nord-Gudbrandsdal attended a course in heart lung resuscitation and all the ambulance personnel were trained and certified to use Heartstart 2000 semiautomatic defibrillators.
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Tidsskr. Nor. Laegeforen. · Sep 1992
[Results of treatment--the Nord-Gudbrandsdal Project--circulatory collapse in sparsely populated regions].
In Project Nord-Gudbrandsdal we aimed to reduce prehospital mortality from myocardial infarction in a sparsely populated area. The ambulance system consisted of local ambulances with semi-automatic defibrillators (the ambulance personnel were trained in the use of these), combined with advanced medical support from the local doctor and/or the air ambulance doctor. ⋯ Four patients were discharged from hospital in a satisfactory condition. We discuss the factors determining successful resuscitation.