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P Sefrin

Publications and source records attributed to P Sefrin.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Resuscitation in the field of intensive care medicine: comparison of two periods of anesthesiologic intensive care separated by 10 years].

Acute failure of vital functions is more likely to occur in patients in intensive care units (ICU) than in peripheral wards. In this retrospective study, which analyzes the cases over two distinct 1-year periods separated by a 10-year interval, we have attempted to reflect the results obtained in our own ICU and to compare them with data reported in the literature. One hundred thirty-three patients requiring cardiopulmonary resuscitation were entered in the study. Over the 10-year interval, the survival rate increased. The number of patients that could be successfully resuscitated increased from 75.7% to 89.6%, and the rate of survivors discharged from hospital increased from 22.5% to 42.8%. During the first study period 17.8% of resuscitated ICU patients could be discharged with a good prognosis; 10 years later the rate was 32.7%. Possible explanations for the improved outcome could be the more restrictive resuscitation policy and the decreased mean age of resuscitated patients. Earlier detection of threatening complications and improvements in resuscitative measures could also be responsible for the more favorable outcome. During the first study period, 64.3% of patients died if resuscitation had to be started on peripheral wards, whereas in the second study period 63.2% survived. These results indicate the importance of improved resuscitation training programs for the entire hospital staff. Furthermore, over the 10-year interval the reason for admission has changed from traumatized patients to individuals suffering from acute respiratory failure. A comparison of our results with data reported by others could be hampered by the use of different criteria as well as by the differences in patient populations treated. For this reason, widely accepted common criteria should be established for further epidemiological studies.

Anesthesia↗
PubMed1986

[Resuscitation by laymen?].

Although some authors report an increase in the rate of successful resuscitation if cardiopulmonary resuscitation is initiated by laymen, no appropriate training is carried out in the Federal Republic of Germany. In a test comprising 647 persons we studied to what extent it is possible to impact first aid know-how to bystanders. 60% were in the position to recognise the presence of distinct signs of respiratory failure and to assess the situation correctly. Only one-third (35%) of the participants, who had taken the first-aid course more than two years before the test, were able to carry out a proper examination of the respiration. The technique of ventilation was definitely deficient. Already one year after the instruction 30% found it difficult to position the head correctly. More than two years after the instruction 39% of the tested persons were able to insufflate a sufficient tidal volume. In a second test 198 emergency medical technicians were examined who had taken part in a cardiopulmonary resuscitation course. Only 53.2% had sufficient theoretical knowledge. 40% could apply efficiently the single-person-method of basic life support and 55% the corresponding two-person-method. These results prove that a once-only instruction of bystanders does not suffice by itself to impart sufficient knowledge for handling the emergency situation. It is, therefore, proposed to introduce compulsory and continuing instruction as a progressive teaching schedule--especially to young people--in first aid and, integrated into this programme, the methods of cardiopulmonary resuscitation.

Female↗
PubMed1985

[Narcosis within the scope of preclinical care].

Narcosis applied in emergency care is a possibility of offering pain relief to the emergency patient. Over and above this, however, it has become increasingly important to prevent pathophysiological changes resulting from the state of shock of the patient. Nevertheless, this measure should be restricted to skilled personnel only, provided of course that the emergency service in question is adequately equipped both technically and with suitable drugs. A decisive role is played by the drugs selected for this purpose. The article describes the pros and cons of various drugs administered via the intravenous route to induce narcosis. So far, there is no ideal drug for this purpose. It will always be necessary to arrive at a compromise and to adapt the drug to the individual situation and to the extent of basic damage suffered by the emergency patient.

Analgesia↗