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At least 379 records · Page 21Linked to original sources
PubMed1995

Variations in cardiopulmonary resuscitation techniques: past, present and future.

OBJECTIVE: To review the major changes and advances in cardiopulmonary resuscitation (CPR) since its first description over 100 years ago. DATA SOURCES: A MEDLINE search of the English literature (1966 to 1994) was done using the key words 'cardiopulmonary resuscitation', 'CPR', 'heart massage', 'techniques' and 'methods'. STUDY SELECTION: Articles were selected based on content related to promising CPR techniques and specifically on alternate methods of closed chest compression. DATA EXTRACTION: Performed independently by the authors. DATA SYNTHESIS: Over the past three and a half decades, the importance of rapid institution of CPR has become increasingly recognized. This has led to a strenuous effort to educate the public in CPR delivery in addition to making definitive treatment with emergency medical systems more readily accessible. Furthermore, as the physiology of closed chest massage has become better understood, investigators have been able to focus their efforts appropriately to exploit the mechanisms that are operative during CPR. As a result, several modifications have been proposed in adjuvant therapies administered concomitantly with CPR, as well as in new, innovative methods of CPR delivery. Many of these changes and new methods show promise for improving vital organ perfusion and patient survival. CONCLUSIONS: CPR has become increasingly recognized as an important element in the chain of survival for victims of cardiopulmonary arrest. Several advances in delivery and technique have resulted in improved resuscitation of cardiopulmonary arrest victims. However, despite these advances, additional research is needed to improve further the still dismal overall survival of victims of cardiopulmonary arrest.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

[Suicidal poisoning with verapamil].

An 18-year-old woman treated in an internal medicine department for heart complaints took clandestinely a high dose of verapamil of unknown origin. She was transferred with block grade III and blood pressure fall to the Department of Cardiology, Province Hospital, where she came with severe cardiogenic+ shock. Resuscitation--electric stimulation (external and then endocavitary), heart massage, artificial ventilation, and the drugs used (orciprenaline, atropine, dopamine, calcium)--was unsuccessful, since despite the bioelectrically effective stimulation myocardial contraction were not achieved, which was probably due to deficit of calcium necessary for activation of contractile elements in muscle fibres. The toxicological investigation demonstrated verapamil (together with its metabolites) in the blood (6 micrograms/ml) and in the liver (42 micrograms/g of tissue).

Adolescent↗
PubMed1993

[Mechanical circulatory support for profound heart failure].

Profound heart failure, such as acute myocardial infarction with cardiogenic shock and postcardiotomy ventricular failure, requires mechanical circulatory support when recent medical treatment is ineffective. Intra-aortic balloon pumping, venoarterial bypass, cardiopulmonary bypass, left ventricular bypass, biventricular bypass and left ventricular assist device are commonly used circulatory support methods. Type selection and application timing of circulatory supports, based on the understanding of type of cardiac failure, respiratory function and other organ conditions, appears to be most important for successful treatment of profound heart failure.

Assisted Circulation↗
PubMed1993

[The physician and accidents. Legal and medical problems].

German law requires that any physician at a place of accident is obliged to help according to his training and ability. As an emergency doctor on duty he works in a warrantee position. In cases with multiple accident victims triage may be necessary, corresponding to the priority of medical care. In criminal procedures against a physician due to omitted help, there is no probative charge against the accused. On the other hand, civil law sets up an objective standard: attention as required in communication. In giving initial medical assistance for unconscious patients or injured children, rules of "authorized management without commission" become valid. Basic first aid measures involve: securing, saving and rescue. Life-threatening situations such as severe bleeding, airway obstruction and cardiac arrest must be dealt with immediately. Following this, such measures as proper positioning, clearing of the respiratory tract, removal of dental prostheses, evaluation of multiple injuries, avoidance of hypothermia and initiating infusions are mandatory. The orientating examination of the accident victim is described, as is the "ABCD Rule" for treating respiratory insufficiency or circulatory arrest and shock, using heart massage and artificial respiration. Finally, medical first aid is described for special injuries, such as cerebral or thoracic trauma, fractures and burns. The psychological situation affecting the physician at the place of an accident is characterized.

Accidents↗