Medicore Medical Services Blog

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Everything related to resuscitation, and resuscitation based activities. 

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Should the manikin die in a simulated resuscitation?

Should the manikin die in a simulated resuscitation?
There's an interesting article and accompanying editorial blog in the current edition of Pediatrics http://pediatricsblog.blogspot.ie/2015/06/should-manikin-die-in-mock-code.html
 
Anyone who attends, or teaches on, resuscitation courses will know how they usually pan out. The student is faced with a manikin and led through a scenario, where the manikin is critically ill. If a predetermined algorithm is followed, the scenario inevitably ends with the "patient" making a good recovery.
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Surviving Two Hours of Ventricular Fibrillation

Surviving Two Hours of Ventricular Fibrillation
Case Report A 42-year-old man was found unresponsive to external stimuli and pulseless at an outdoor temperature of 1°C. CPR was started at the scene by laypersons, and the emergency medical services (EMS) arrived 5 minutes after the emergency call. Resuscitation was initiated by EMS. The first recorded rhythm was ventricular fibrillation (VF), which persisted, despite repeated defibrillation. The patient showed signs of severe hypothermia and, during ongoing CPR, was transported to hospital where on arrival the patient's rectal temperature was measured at 22°C. Resuscitation measures were continued and warming was started at the emergency room. Due to persistent VF and deep hypothermia, the patient was transferred to a cardiothoracic surgical unit for rewarming with ECC. At commencement of ECC, CPR had been going for approximately 130 minutes and a total of 38 defibrillations had been made. During this time interval the patients was pulseless. At a core temperature of...
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They're Not Dead Until They're Warm and Dead

They're Not Dead Until They're Warm and Dead
A recent case report in the Prehospital and Disaster Medicine Journal documents the return of spontaneous circulation in a surfer pulled from the water by a rescue team some 90 minutes after entering.    Drowning, Hypothermia and Cardiac Arrest: An 18-year-old Woman with an Automated External Defibrillator Recording.   This report describes the case of an 18-year-old woman who was found in the sea suffering from cardiac arrest and hypothermia, 90 minutes after she entered the water to swim. The rescue team used an automated external defibrillator to record prehospital management. This recording showed an isoelectric electrocardiogram followed by a ventricular fibrillation, an unsuccessful defibrillation, and lastly, a return of spontaneous circulation with Osborn wave. When she was admitted to the intensive care unit two hours later, the woman's central temperature was 28°C. The case is interesting because of several points. First, to the best of the authors' knowledge, this is...
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Wrist injury during chest compressions

Wrist injury during chest compressions
A new research paper published in the Journal of Emergency Trauma, and Shock has looked at the possible injury to the rescuers wrist while giving chest compressions.    The article describes the relationship between the amount of force needed to externally compress the chest the required depth and the possible injury to the rescuers' wrist, namely the scapholunate ligament The amount of force neccessary to compress the chest was recorded as being as much as 644 N (newtons), which equates to a (kilogram-force) of 65.6 Kgf. The article proposes that the forces transmitted through the rescuers' wrists in the performance of external chest compressions during CPR are suffice to cause injury to the scapholunate ligament of the rescuer, potentially resulting in further cumulative trauma, degenerative changes, and eventual disability. Further biomechanical studies specific to this particular population should be performed. The article makes an observation: "Compensation for worker injury maybe involved" No...
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Audio: Dramatic 911 Call Details Heroic Measures to Save Baby's Life

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