Resuscitation
-
The Federal Islamic Republic of the Comoros lies off between Madagascar and the Southeast Coast of Africa, and comprises a group of three islands with a total population of 651,901. The average annual income per capita is US$ 470 and life expectancies at birth are 59.3 years for men and 63.9 years for women. ⋯ The main focus of emergency medicine is disaster management and hospital-based clinical practice. There is a paucity of literature on emergency medicine in Comoros and this is the first article to report the current status of emergency medicine in Comoros Islands.
-
We present a case of a patient with severe multiple trauma who was treated at the scene by a physician-staffed trauma life support team. Due to a complete tracheal transection, a "cannot ventilate, cannot intubate"-situation occurred. The patient was then intubated using a fiberoptic bronchoscope in the prehospital setting. The current literature concerning fiberoptic intubation in emergencies is discussed.
-
Randomized Controlled Trial
The impact of the ILCOR 2005 CPR guidelines on a physical fitness assessment: a comparison of old and new protocols.
St. John Ambulance Australia has used the performance of CPR for 10 min as a fitness test for its members. Recent changes in international guidelines for cardiopulmonary resuscitation caused concern that the new ILCOR protocol was more strenuous than the previous one. This study compared the two protocols to determine if there were significant differences and to allow an evidence-based decision on the continuation or modification of this practice. ⋯ The new protocol increases both objective and subjective measures of effort. While the absolute differences in workload are small, they are statistically significant. There are significant indicators of this difference in the first 3 min of assessment. Rescuers are more likely to be operating at a high-level of physical activity. To avoid increasing the demands of its mandatory fitness test, St. John should reduce the required performance time from its present 10 min.