Resuscitation
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Our objectives are to describe details of the dispatcher assisted cardiopulmonary resuscitation (CPR) instruction program we implemented during a 12 years study and to provide estimates of the potential number of out-of-hospital cardiac arrests that might benefit from such instruction based on data from the last 77 months. ⋯ In the city of Seattle, some 29.9% of all out-of-hospital cardiac arrest victims who received ACLS had the potential to benefit from dispatcher assisted CPR.
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Do not attempt resuscitation (DNAR) decision-making and recording in case notes can be poor. We have audited current practices pertaining to DNAR orders in a district hospital before and after the introduction of a standardised order form (SOF). ⋯ Documentation of DNAR decisions in medical case notes is poor. Standardised order forms, based on recommended national guidelines that complement case note entries, improve the process and recording of this sensitive decision.
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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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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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To determine effective interventional targets for out-of-hospital cardiac arrests by analyzing the distribution characteristics of arrest patients according to age and sex with special emphasis on ventricular fibrillation (VF). ⋯ Our study provides evidence that there are significant age and sex related epidemiological differences in cardiac arrests and we need to understand them better. Strategies that focus on high yielded patients, those in witnessed VF, should be pursued. These efforts should be expected to yield sex and age related differences in survivors.