Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Perimortem cesarean section is rarely required in the ED. However, since trauma now represents a leading cause of nonobstetric maternal death, emergency physicians (EPs) may more commonly be faced with the difficult decision of performing an emergency cesarean section. Two cases are described of severely traumatized pregnant patients for whom perimortem cesarean section in the ED led to birth of viable infants, with one long-term survivor. The rationale and guidelines for the procedure are discussed, and it is emphasized that the EP should be thoroughly familiar with the procedure and prepared to perform it when indicated to enhance fetal (and potentially maternal) survival.
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To describe ventilatory dynamics following the onset of ventricular fibrillation (VF) in an experimental swine model. ⋯ In this swine model, 11 of 12 (92%) continued to have spontaneous agonal respirations for the first 3 minutes of VF cardiac arrest. Many animals had supranormal tidal volumes, and near-normal minute ventilations. These findings have potential implications for lay-rescuer and first-responder contributions to resuscitation of victims of out-of-hospital cardiac arrest.