Resuscitation
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The mechanism of blood flow in cardiopulmonary resuscitation remains controversial. Inconsistencies in the cardiac pump model necessitated the development of the thoracic pump. ⋯ We explore the mechanism and effect of this hypothesis and match it to previous observations. The implications to cardiopulmonary resuscitation are addressed.
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Though mouth-to-mouth resuscitation (MMR) is widely endorsed as a useful lifesaving technique, studies have shown that health care professionals are reluctant to perform it. To characterize the circumstances which facilitate this reluctance among physicians, we have surveyed current and future residency trainees regarding attitudes toward providing ventilation by this method to strangers experiencing arrest in the community. ⋯ Many physicians and future doctors are reluctant to perform MMR on arrest victims in the community, a trend that increases in prevalence among those with more residency training. These data support the hypothesis that diminished helping behavior occurs gradually over the training period and may occur as a direct consequence of the training experience. A model for characterizing the elements that make up a rescuer's decision process is proposed.
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Case Reports
Gastric rupture--an uncommon complication after successful cardiopulmonary resuscitation: report of two cases.
Gastric rupture is a poorly described complication following cardiopulmonary resuscitation. An incidence of 0.1% has been reported in the literature. Published reports describe traumatic gastric rupture after use of the CardioPump, after mouth-to-mouth ventilation, and in children after resuscitation performed by paramedics. ⋯ This patient died on the 6th postinterventional day. Gastric rupture rarely occurs after cardiopulmonary resuscitation. The causes of gastric rupture and the means to avoid this complication will be discussed.