[Indications for house calls. Experiences of the organized emergency service of a structured rural district].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to N Roewer.
Explore the source record for details and available documents.
This investigation is based on 140 autopsy protocols of unsuccessful resuscitation procedures (Resuscitation Center of the Army Hospital, Hamburg); injections and closed-chest cardiac massage had been performed in every case. - Most of the patients had collapsed because of cardiac shock; patients with thoracic or abdominal injury were excluded from this study. In individual cases only, the following severe complications originated from the resuscitation procedures: fracture of a chest vertebra, serial fractures of ribs resulting in an unstable thorax, bilateral haemothorax, tension pneumothorax, rupture of kidney and of spleen (but not of liver). In one case the lesions caused by the resuscitation measures must be considered as responsible for the lethal outcome. Fractures of ribs and/or sternum were found in 45.9% of all cases, the frequency increasing with age. The number of fractured ribs ranged up to 16, mainly 3-8 ribs were fractured. Fractures of rib No. 1 and 8-12 were very rare. The fractures were located between the parasternal and axillary lines.--In a comparative study the site of rib fractures after heavy blunt thoracic injuries was preferably found in the dorsal region.
Programmed electrical stimulation of the heart was performed in a 40-year-old man with documented recurrent, sustained ventricular tachycardia, which had proved refractory to standard medical therapy. In this patient, both the presence of several discontinuities in the atrioventricular (AV-)nodal conduction curves during atrial and ventricular stimulation and the varying time intervals of the AV-nodal echo phenomena suggested the presence of multiple AV-nodal pathways.
Three cases of severe carbon monoxide poisoning are described presenting with deep coma, generalised extensor spasms and myoclonia as symptoms of acute midbrain syndrome. Despite this poor prognosis all patients survived without essential neurological impairment. This favourable outcome is thought to be due to the administration of thiopentone for the amelioration of hypoxic brain damage in dosages commonly employed in anaesthesia.