Resuscitation
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Comparative Study
Experience with ketamine and sodium pentobarbital as anesthetics in a rat model of cardiac arrest and resuscitation.
We review 7 years experience with the chest compression model of cardiac arrest and resuscitation, comparing two different anesthetics. Ketamine stimulates cardiac function and only mildly depresses respiration; of the two it provides easier resuscitation. ⋯ Sodium pentobarbital mildly depresses brain protein synthesis, but depresses both cardiac and respiratory function, making resuscitation more difficult. Use of alternate chest/abdominal pumping (Babbs resuscitation technique), with judicious use of intra-cardiac epinephrine (adrenaline), made resuscitation reliable under sodium pentobarbital as well.
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We present a case report of successful treatment of shock induced by the calcium channel blocker (CCB) diltiazem. A 75-year-old woman took a combination of tablets, including diltiazem. ⋯ Haemodynamic stability was not achieved until an insulin infusion and glucose administration was started. We review the literature and the updated guidelines for the treatment of CCB intoxication, with particular emphasis on situations where insulin and glucose infusions can be live saving.
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Cardiopulmonary Resuscitation is an important component of the pre-hospital emergency care process. Location of the correct site for application of compression in External Cardiac Compression is crucial if patients are not to be exposed to the risk of iatrogenic injury. ⋯ Results indicated that, using the most conservative comparison, such pressure would be applied in 97% of instances, if the rescuer strictly adhered to the caliper method for locating the correct site. It is recommended that the caliper method be removed as an approved procedure.
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Comparative Study
Prehospital ECG transmission: comparison of advanced mobile phone and facsimile devices in an urban Emergency Medical Service System.
To compare the speed and reliability of electrocardiogram (ECG) transmissions from the prehospital setting to a conventional table facsimile device and to an advanced mobile phone in a Helicopter Emergency Medical Service System (HEMS). ⋯ An advanced mobile phone is as fast and reliable as a conventional table fax in receiving ECGs. A mobile phone with advanced features is a practical tool for HEMS physicians who need to evaluate ECGs in the prehospital setting.
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Myocardial dysfunction occurs immediately after successful cardiac resuscitation. Our purpose was to determine whether measurement of cardiac troponin I in children with acute out-of-hospital cardiac arrest predicts the severity of myocardial injury. ⋯ After cardiac arrest and resuscitation in pediatric patients, the severity of myocardial dysfunction was reflected in troponin I levels.