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Biomedical subjects

N Donen

Publications and source records attributed to N Donen.

22 records · Page 2Linked to original sources
PubMed1980

Resuscitation from cardiac arrest: assessment of a system providing only basic life support outside of hospital.

Resuscitation outside of hospital of victims of cardiac arrest is a major challenge to our emergency care system. Most cities in Canada do not have a mobile advanced life support service; instead they rely on basic life support outside of hospital. The outcome in such cases and the factors affecting the outcome are largely unknown. Thus, it is difficult to estimate the lifesaving potential of adding advanced life support to the existing measures available for care outside of hospital.A prospective study of all resuscitation attempts begun outside of hospital was conducted during 18 consecutive months in 1977-78 in Winnipeg; at that time only basic life support was available outside of hospital. Resuscitation was attempted 849 times, and 33 patients (4%) survived to be discharged from hospital. Data analysis revealed that: (a) none of the 58% of patients in asystole at the time of arrival at a hospital survived to be discharged, but 11% of the patients with ventricular fibrillation or tachycardia (27% of the entire group) survived; (b) the survival rate was lower when the interval from the emergency telephone call to the patient's arrival at the hospital exceeded 10 minutes; and (c) basic life support was begun immediately in 29% of the patients with ventricular fibrillation or tachycardia, and increased the survival rate fivefold.The training of private citizens in basic life support is a vital component of total emergency cardiac care. A mobile advanced life support service will be effective in saving lives if it reduces the delay before definitive care is instituted, preferably to less than 10 minutes.

Ambulances↗
PubMed1980

Evaluation of hospital-based cardiac resuscitation, 1973--77.

The resuscitation experience of a large teaching hospital during 1973-77 was reviewed. Resuscitation was attempted on 2091 victims of cardiac arrest; 261 patients (12.5%) survived to be discharged from hospital.Coronary heart disease caused about one half of all the cardiac arrests, but was associated with a better survival rate (14.4%) than the other causes. Cardiac arrest following multiple trauma had the worst prognosis; only 3% of the patients survived to be discharged from hospital. However, the main factor influencing outcome was the site of arrest. The survival rates of patients on whom resuscitation was initiated in the emergency room or an intensive care area were triple and double the rate for patients in hospital wards, although one third of all the cardiac arrests induced by a coronary event and occurring in hospital were on the wards. Patients whose arrest occurred outside hospital, where only basic life support was available, had a survival rate of just 6.3%, whereas those whose arrest occurred in the emergency room had a survival rate of 31.9%. Since these two patient groups were similar in terms of age and diagnosis, we believe that the potential survival rate for victims of cardiac arrest outside of hospital that are optimally treated is close to 30%.These data suggest that increased survival from cardiac arrest can be expected with extension of the resuscitation services both inside and outside of hospital, but particularly with increased emphasis on emergency cardiac care outside of hospital.

Adolescent↗
PubMedDate not supplied

Diazoxide in the management of chlorpropamide overdose.

Three cases of chlorpropamide overdose are reported. Plasma levels of chlorpropamide, diazoxide, glucose, and insulin are presented for each patient during treatment. The simultaneous analysis of chlorpropamide, hydrochlorothiazide, and diazoxide in plasma by high pressure liquid chromatography (HPLC) is also reported. Although all three cases presented at hospital with potentially lethal plasma levels of chlorpropamide, each was successfully treated with intravenous diazoxide and glucose. Plasma diazoxide concentrations between 50-100 microgram/mL appear to be optimal in achieving therapeutic control of chlorpropamide induced hypoglycemia.

Adolescent↗