Resuscitation
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Emergency medical services (EMS) in South Africa have developed rapidly over the last 20 years. However, there is inequitable distribution of services, with many rural areas being poorly resourced. This is partly as a result of the historical inequalities prevalent in the South African society of the past; efforts are being made to address this. ⋯ The introduction of emergency medicine as a new full speciality in 2004 will transform emergency care in Southern Africa, and appropriate training programmes are already being developed, together with progressive upgrading of emergency departments. EMS personnel face a vast spectrum of clinical cases, particularly all forms of trauma. Recent improvements in organisation, education and resources, coupled with better distribution of services, upgraded emergency departments and the development of emergency medicine as a speciality, should provide a significant boost for emergency care for the community.
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Review Historical Article
Open-chest cardiopulmonary resuscitation: past, present and future.
Out-of-hospital cardiac arrests account for approximately 1000 sudden cardiac deaths per day in the United States. Since its introduction in 1960 closed-chest cardiac massage (CCCM) often takes place as an attempt at resuscitation, although its survival rates are low. Other resuscitation techniques are available to physicians such as open-chest cardiopulmonary resuscitation (OCCPR). ⋯ Surprisingly, the incidence of infectious complications after thoracotomy in an unprepared chest is low. The vast majority of the patients' families accept OCCPR as a therapeutic choice for cardiac arrests and it has been showed to be economically viable. This paper reviews some of the basic and advanced concepts of this evolving technique.