Resuscitation
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Biography Historical Article
The resuscitation greats. Henning Ruben MD, FFARCS(I), FFARCS. The Ruben valve and the AMBU bag.
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Monitoring of end-tidal carbon dioxide (EtCO(2)) is good clinical practice in the patient who is intubated and ventilated. This study investigated the EtCO(2) values in spontaneously breathing patients treated in a physician-staffed mobile intensive care unit (MICU). This article also discusses whether EtCO(2) monitoring may have an influence on therapeutic decisions by emergency physicians by providing additional information. ⋯ Although EtCO(2) monitoring may be a useful additional variable in spontaneously breathing patients. Consideration of the respective disease and the cost to benefit ratio suggests that this method should only be used for selected indications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Is the orientation of the apical defibrillation paddle of importance during manual external defibrillation?
Transthoracic impedance (TTI) is a factor determining the magnitude of the transmyocardial current during external defibrillation. Minimising TTI increases the chances of successful defibrillation. Most external defibrillation paddles are rectangular in shape and can, therefore, be placed in a transverse or longitudinal orientation. The apical paddle is often placed in a transverse orientation. This may theoretically result in a higher TTI than a longitudinal orientation because of poorer contact at the lateral paddle edges. We compared TTI with the apical paddle in both a transverse and longitudinal orientation. ⋯ The longitudinal orientation of a rectangular defibrillation paddle provides a lower TTI than orientation horizontally.