Resuscitation
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In trauma management, the importance of early and effective control of the airway is acknowledged universally. Attention to the airway is particularly vital when a casualty has sustained serious head or facial injuries. ⋯ A case is described in which the intubating laryngeal mask airway (ILMA or LMA-Fastrach) was used successfully in the pre-hospital setting to secure the airway of a patient who had sustained serious head and facial injuries in a road traffic collision. The indications for the use of the ILMA in pre-hospital care are discussed.
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Electrode polarity may alter the success of biphasic shocks from implantable systems. Whether the electrode polarity influences the success of transthoracic biphasic defibrillation is unknown. We determined the effect of electrode polarity on biphasic transthoracic defibrillation in a porcine model. ⋯ In this porcine model of transthoracic defibrillation, varying the biphasic shock electrode polarity did not alter transthoracic defibrillation success. Positional labeling of transthoracic biphasic defibrillation electrode pads may be unnecessary.
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Comparative Study
Delayed platelet dysfunction in prolonged induced canine hypothermia.
Mild to moderate hypothermia (33-32 degrees C) is recognized as beneficial for brain protection after brain trauma. However, there are few experimental reports on hemostatic changes during prolonged hypothermia. We compared hemostatic changes during 72 h of mild to moderate hypothermia with data in normothermic dogs. ⋯ Long-term hypothermia induced platelet dysfunction, leading to decreased platelet aggregation and prolonged coagulation time (R and K times of TEG).
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To describe the epidemiology, resuscitation factors and prognosis among a consecutive population of patients suffering from out-of-hospital cardiac arrest (OHCA) where pulseless electrical activity (PEA) was the first arrhythmia recorded on emergency medical services (EMS) arrival. ⋯ Survival among patients suffering from OHCA and PEA is poor, especially among the elderly unwitnessed cases and those who do not receive bystander CPR. The latter seems to be of utmost importance among these patients.
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To describe our outcomes using thrombolysis during the cardiopulmonary resuscitation (CPR) of patients in cardiorespiratory arrest (CA) caused by fulminant pulmonary embolism (FPE). ⋯ Early thrombolysis during CPR manoeuvres for CA apparently caused by an FPE may reduce the mortality rate among these patients.