Articles: emergency-medicine.
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A two-year study of 198 consecutive patients treated for cardiac arrest in the emergency department at Stanford University Medical Center was undertaken. The relatively poor overall survival rate of 3% and the complexity of deciding how to treat cardiac arrest victims suggest the need for guidelines to assist the emergency physician when resuscitating cardiac arrest patients. From the above study and a survey of the literature, the authors formulated the following guidelines of when resuscitation should be discontinued or not attempted: Cases of apnea and pulselessness known to have exceeded 10 minutes, no response after more than 30 minutes of advanced cardiac life support (ACLS), no ventricular EKG activity after more than 10 minutes of ACLS, and preexisting terminal illness.
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Medical instrumentation · Nov 1977
Comparative StudyThe clinical assessment of cardiovascular emergencies.
Data are given for a 2-year study of fire department ambulance runs in Houston, Texas. Comparisons are made between those runs in which telemetry was used and those in which telemetry was not used. ⋯ Criteria used for clinical assessment and classification of emergencies are discussed. Emergency life-support systems with telemetry can have significant benefit for certain selected acute, recognizable cardiovascular emergencies, but the majority of ischemic heart disease fatalities do not appear to be deriving benefit from these systems.
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The Esophageal Obturator Airway, a device designed for use in the management of cardiopulmonary arrest, obstructs the esophagus while simultaneously ventilating the lungs. The EOA was clinically tested in 29,000 patients with a low incidence of false entries and complications. ⋯ It was concluded that whenever optimal conditions for endotracheal intubation are unavailable, the EOA should be first choice in the management of the airway in aneflexic, apneic patients. Specific contraindications are listed.