Resuscitation
-
Motor vehicular accidents (MVA) are the leading cause of death among people under 40 years of age. Despite improvement in car safety and driver awareness of the use of safety devices, fatalities and severe injuries continue to occur. ⋯ According to our data significant association between technical crash data and injury pattern and injury severity can be assumed. In case of high speed MVA in rural areas the trauma mechanism and the circumstances (i.e., impact direction, automobile deformation) should be considered to identify patients at high risk of severe blunt trauma and multiple injuries.
-
The long-term behavioral effects of mild global ischemia have not been well described. We used short (5 min) asphyxic-cardiac arrest that resulted in no apparent gross neurological deficits to study the long-term effects of mild hypoxic ischemia on the neurobehavioral status of rats. ⋯ We present a rodent model of mild CA that, despite apparent full recovery of global neurological function at 24h post-resuscitation, exhibited long-term cognitive injury lasting for at least 2 weeks after CA. This model may help understand better the injury associated with CA and develop management strategies for mild brain injury.
-
Randomized Controlled Trial
Assessment of Advanced Life Support competence when combining different test methods--reliability and validity.
Robust assessment of Advanced Life Support (ALS) competence is paramount to the credibility of ALS-provider certification and for estimating the learning outcome and retention of ALS competence following the courses. The European Resuscitation Council (ERC) provides two sets of MCQs and four Cardiac Arrest Simulation Test (CASTest) scenarios for the assessments according to guidelines 2005. ⋯ ERC sub-tests of ALS competence possess sufficient reliability and validity. A combined ALS score with equal weighting of one MCQ and one CASTest can be used as a single measurement of ALS competence.
-
Clinical Trial
Feasibility and efficacy of a new non-invasive surface cooling device in post-resuscitation intensive care medicine.
There is sufficient evidence that therapeutic hypothermia after non-traumatic cardiac arrest improves neurological outcome and reduces mortality. Many different invasive and non-invasive cooling devices are currently available. Our purpose was to show the efficacy, safety and feasibility using a non-invasive cooling device to control patient temperature within a range of 33-37 degrees C. ⋯ Using the Arctic Sun System in post-resuscitation care medicine for cooling cardiac arrest survivors is feasible and has proven to be highly effective in lowering patients' temperature rapidly without inducing skin irritations.
-
Amniotic fluid embolism (AFE) is a rare, but potentially fatal complication of pregnancy, with an incidence between 1 in 8000 and 1 in 80,000 pregnancies. The pathogenesis is not fully understood, but the generally accepted belief is that amniotic fluid enters the mother's circulation, most commonly via tears in the lower uterine segment. ⋯ AFE after blunt trauma is very rare, only described a few times in the literature. We report a case of fatal AFE after probable minor blunt trauma to the abdomen and give a review of the literature.