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C T Lambrew

Publications and source records attributed to C T Lambrew.

33 records · Page 2Linked to original sources
PubMed1980

Effects of PEEP and of increased frequency of ventilation during CPR.

Previous reports have attributed increased carotid blood flow to lung ventilation during CPR. This study was undertaken to determine whether PEEP (20 torr airway pressure) or increased frequency of ventilation (3:1) improved arterial pressure, flow, and blood gases. Thirty-three domestic pigs were studied using three protocols (standard 5:1 CPR, 5:1 CPR plus PEEP, 3:1 CPR) distributed such that comparisons could be made between groups as well as within the same pig. For intrapig comparisons, PO2 was significantly improve (p less than 0.05) by PEEP (delta PO2 = 9.7 +/- 13.0 torr). PCO2 was significantly less (p less than 0.005) for 3:1 compared to 5:1 (delta PCO2 = -4.7 +/- 2.1 torr). For group comparisons, PO2 was 55.5 +/- 12.9 torr without and 70.1 +/- 16.3 torr with PEEP (p less than 0.025). For 3:1, PO2 was 66.3 +/- 11.6 torr that was greater (p less than 0.10) than for 5:1. When ventilation was temporarily halted, phasic changes in flow with ventilation were replaced by nearly constant flow approximately equal to maximal flow when ventilation was provided. PEEP and more frequent ventilation improved blood oxygenation but at the expense of carotid blood flow.

Animals↗
PubMed1978

Evaluation of physician skills in cardiopulmonary resuscitation.

Thirty-five physicians at various levels of postgraduate training in internal medicine were evaluated for performance skills in cardiopulmonary resuscitation (CPR) according to standards of the American Heart Association. They were given instruction in only the cognitive knowledge related to CPR through lectures and a demonstration of the technique, without supervised manikin practice. Only 22% (8) of the physicians tested were able to adequately compress and ventilate the manikin in a simulated cardiac arrest. Although physicians are proficient in the use of drugs during resuscitative efforts, it is also imperative that they be able to perform basic CPR.

Cardiopulmonary Resuscitation↗
PubMed1968

Electric shock.

Explore the source record for details and available documents.

Electric Injuries↗
PubMedDate not supplied

Factors influencing the time to thrombolysis in acute myocardial infarction. Time to Thrombolysis Substudy of the National Registry of Myocardial Infarction-1.

BACKGROUND: The Time to Thrombolysis Substudy of the National Registry for Myocardial Infarction provided the opportunity to identify factors that delay thrombolytic treatment of patients with ST-segment elevation acute myocardial infarction. PARTICIPANTS: Forty-two participating registry hospitals volunteered for the Time to Thrombolysis Substudy. METHODS: A case report form was developed to collect time points for emergency department arrival (door), recording of the electrocardiogram (ECG) (data), entry of the order to give a thrombolytic drug (decision), and initiation of the thrombolytic infusion (drug) as defined by the National Heart Attack Alert Program. The impact of mode of transportation to the hospital, sex, policy-driven cardiology consultation and/or contact of the primary care physician on door-to-drug time, and each component interval were determined in 1755 patients who were treated with recombinant tissue-type plasminogen activator (A1-teplase). The t test was used for comparison of means and the nonparametric sign test was used for medians. RESULTS: A minority of patients arrived at the hospital by ambulance, although more women (49.6%) arrived by ambulance than men (40.9%). However, women arrived at hospitals significantly later after onset of symptoms than men. It took half as long for patients arriving by ambulance to be seen by the physician than those who transported themselves to the hospital. It took longer for women to have the initial 12-lead ECG recorded than men. The decision to order a thrombolytic agent was delayed by 22 minutes and median door-to-drug time by 21 minutes in those patients who had a cardiac consultation over those in whom the drug was ordered and infusion was initiated by the emergency physician. Although the initial 12-lead ECG showed ST-segment elevation in 86% of patients who received the thrombolytic drugs, with no difference between men and women and no difference in the rate of cardiology consultation between men and women (77%), door-to-decision time and door-to-drug time were substantially longer for women having consultation than men. There was no significant difference in door-to-decision time between men and women when no consultation was performed, but it still took longer for a drug infusion to be initiated in women. Contacting the primary care physician delayed the decision to give a thrombolytic drug by 18 minutes and the administration of the drug by 20 minutes, but there were no differences between men and women. Preparation of the drug in the pharmacy resulted in significant delay compared with mixing it in the emergency department. CONCLUSIONS: Hospital practices and policies, including contacting the primary care physician prior to the initiation of a lytic drug, cardiology consultation, and preparation of the drug in the pharmacy rather than in the emergency department, significantly delay the goal of early treatment of patients with ST segment elevation acute myocardial infarction. Delays in hospital arrival for women are compounded by delays in the decision to treat them with a thrombolytic drug and initiation of the drug therapy in those women who receive consultation compared with men. Other delays in acquiring the first ECG and initiating the drug infusion in women are not explained.

Aged↗