Arctic medical research
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Arctic medical research · Jan 1991
Case ReportsSevere accidental hypothermia: survival after 6 hours 30 minutes of cardiopulmonary resuscitation.
This report describes a severely hypothermic victim, who was treated with conventional cardiopulmonary resuscitation and conventional rewarming technique using warm-water bags, warm fluids intravenously and peritoneal lavage. This case demonstrates more than any previous report that hypothermic victims with cardiac arrest may survive for many hours if CPR is carried out vigorously until core temperature is raised. 6 hours continuous CPR is, as far as the author knows, the longest reported conventional PCR in a hypothermic victim followed by survival.
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Arctic medical research · Jan 1991
Case ReportsAnesthesiologist-manned helicopters and regionalized extracorporeal circulation facilities: a unique chance in deep hypothermia.
Norway has nine light ambulance helicopters, four heavy sea rescue helicopters and seven ambulance air planes in 24-hours duty spread all over the country. Most are manned with anesthesiologists. Five regional hospitals in all parts of the country, offer facilities for extracorporeal circulation. ⋯ She was intubated and received chest compression for 70 minutes until she was rewarmed by extracorporeal circulation. She was discharged without signs of cerebral damage. The decision to bypass less advanced hospitals en route to the regional hospital proved correct in this case, and is suggested as standard procedure in deep hypothermic patients.
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The characteristics of "epidemic" suicides in native communities are discussed. It is hypothesized that the suicides are but one of many indicators of general community disorganization and problems. It is felt that concentration on the suicide problem although necessary, may detract from efforts at remedying the basic problems. Three communities are used to illustrate their "dynamics" and some principles of crisis intervention in such situations are presented.
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Cold stress may be present in terms of a risk for skin surface cooling (wind chill), extremity cooling and whole body cooling. Measures of cold stress differ for the various situations. ⋯ The cooling power can be easily converted into a required insulation value, that applies both to parts of the body and to the body as a whole. The value provides information about cold stress in two ways; (a) by specifying necessary behavioural adjustments in terms of required activity level and clothing insulation level, and (b) by quantifying the thermal imbalance and tolerance time, when protection worn does not provide sufficient insulation.