Resuscitation
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Randomized Controlled Trial
Disposable laryngeal tube suction--a randomized comparison of two insertion techniques performed by novice users in anaesthetised patients.
Laryngeal tubes are supraglottic airway devices that can be used in alternative to a tracheal tube to provide ventilation during cardiopulmonary resuscitation. The product line has recently been expanded by the disposable laryngeal tube suction (LTS-D). We tested the hypothesis that, with a modified insertion technique (MIT), the rate of correct placement attempts within 45 s could be significantly increased compared to the standard insertion technique (SIT) recommended by the manufacturer. ⋯ Applying a MIT significantly reduced the time for successful insertion of an LTS-D by first-time users. Insertion within 45 s was significantly more frequent with this technique. Further studies need to be conducted to determine if the LTS-D can be recommended as a first-line airway during cardiopulmonary resuscitation.
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The increase in oxidative stress following neonatal hypoxia-reoxygenation can be related to subsequent cardiovascular deficits. We compared the acute systemic, pulmonary and regional hemodynamic recovery in hypoxic newborn pigs reoxygenated by low (18%) or high (100%) concentration of oxygen with that by 21% oxygen. ⋯ In this swine model of neonatal hypoxia-reoxygenation, resuscitation with 18% and 100% oxygen results in differential compromises in systemic and pulmonary circulations when compared with 21% oxygen.
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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.
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In Lithuania pre-hospital medical services were started at the end of the 19th century. Emergency care for patients is provided free of charge and funded from a Compulsory Health Insurance Fund and by Government. ⋯ In the near future it is expected that paramedics will replace ambulance drivers. The emergency medical system is in a transition period: Admission departments are developing into emergency departments, residency programmes for emergency medicine are being prepared, and emergency medicine is going to be recognised as a separate specialty.
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Comparative Study
Characteristics and outcome among patients suffering out-of-hospital cardiac arrest due to drowning.
To describe the characteristics and outcome among patients with out-of-hospital cardiac arrest (OHCA) caused by drowning as compared with OHCA caused by a cardiac etiology (outside home). ⋯ Among patients with OHCA 0.9% were caused by drowning. They had a similar survival rate to 1 month as compared with OHCA outside home with a cardiac etiology. The factor associated with survival was the ambulance response time; a higher survival with a shorter response time.