Resuscitation
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Practice Guideline Guideline
European Resuscitation Council Guidelines 2000 for Adult Basic Life Support. A statement from the Basic Life Support and Automated External Defibrillation Working Group(1) and approved by the Executive Committee of the European Resuscitation Council.
The European Resuscitation Council (ERC) last issued guidelines for Basic Life Support (BLS) in 1998 [1]. These were based on the "Advisory Statements" of the International Liaison Committee on Resuscitation (ILCOR) published in 1997 [2]. ⋯ The Basic Life Support and Automated External Defibrillation Working Group (BLS&AED Group) has considered this document and has recommended changes in the ERC BLS guidelines. These are presented in this paper.
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The frequency spectrum of the ECG in ventricular fibrillation (VF) correlates with myocardial perfusion and might predict defibrillation success defined as return of spontaneous circulation (ROSC). The predictive power increases when more spectral variables are combined, but the complex information can be difficult to handle during the intensity of CPR. We therefore developed a method for expressing this multidimensional information in a single reproducible variable reflecting the probability of defibrillation success. ⋯ The function "Probability of defibrillation success" (P(ROSC)(v)) was developed by a 2-dimensional histogram technique. P(ROSC)(v) discriminated between shocks followed by ROSC and No-ROSC (P<0.0001). The present methodology indicates a possible way to develop a CPR monitor.
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No existing device for cardiopulmonary resuscitation (CPR) is designed to exploit both the "cardiac pump" and the "thoracic pump" effect simultaneously. The purpose of this study was to measure the haemodynamic effect of a new simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device that could compress the sternum and constrict the thoracic cavity simultaneously in a canine cardiac arrest model. After 4 min of ventricular fibrillation, 24 mongrel dogs were randomized to receive standard CPR (n=12) or SST-CPR (n=12). ⋯ SST-CPR generated higher coronary perfusion pressure than standard CPR (47.0+/-11.4 vs. 17.3+/-8.9 mmHg, P<0.01). End tidal CO(2) tension was also higher during SST-CPR than standard CPR (11.6+/-6.1 vs. 2.17+/-3.3 mmHg, P<0.01). In this preliminary animal model study, simultaneous sternothoracic cardiopulmonary resuscitation generated better haemodynamic effects than standard, closed chest cardiopulmonary resuscitation.
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Biography Historical Article
Franz Kuhn, his contribution to anaesthesia and emergency medicine.
Franz Kuhn (1866-1929), a German surgeon, made a significant practical and scientific contribution towards the development of modern anaesthesia and emergency medicine. He developed modern, scientifically based concepts in close correlation to practical inventions for every day use. ⋯ In the early 20th century, he wrote several papers on this topic including a remarkable monograph, dealing with the techniques, indications in anaesthesia and emergency medicine and his experiences of endotracheal intubation. Due to a dispute with Sauerbruch on the methods of avoiding a pneumothorax during thoracic surgery and the development of local and regional anaesthesia techniques, the value of his work and his revolutionary ideas were not appreciated until 40 years later.