A new kind of flow gating interface (FGI) has been designed for online connection of CE with flow-through analytical techniques. The sample is injected into the separation capillary from a space from which the BGE was forced out by compressed air. A drop of sample solution with a volume of 75 nL is formed between the outlet of the delivery capillary supplying the solution from the flow-through apparatus and the entrance to the CE capillary; the sample is hydrodynamically injected into the CE capillary from this drop. The sample is not mixed with the surrounding BGE solution during injection. The functioning of the proposed FGI is fully automated and the individual steps of the injection process are controlled by a computer. The injection sequence lasts several seconds and thus permits performance of rapid sequential analyses of the collected sample. FGI was tested for the separation of equimolar 50 μM mixture of the inorganic cations K+ , Ba2+ , Na+ , Mg2+ , and Li+ in 50 mM acetic acid/20 mM Tris (pH 4.5) as BGE. The obtained RSD values for the migration times varied in the range 0.7-1.0% and the values for the peak area were 0.7-1.4%; RSD were determined for ten repeated measurements.
Acute coronary syndrome is a common cause of sudden cardiac death. We present a case report of a 60-year-old man without a history of coronary artery disease who presented with ST-elevation myocardial infarction. During transportation to the hospital, he developed ventricular fibrillation (VF) and later pulseless electrical activity. Chest compressions with LUCAS 2 (Medtronic, Minneapolis, MN) automated mechanical compression-decompression device were initiated. Coronary angiography showed total occlusion of the left main coronary artery and primary percutaneous coronary intervention (PCI) was performed. After the PCI, his heart started to generate effective contractions and LUCAS could be discontinued. Return of spontaneous circulation was achieved after 90 minutes of cardiac arrest. The patient died of cardiogenic shock 11 hours later. An autopsy revealed a transmural anterolateral myocardial infarction but also massive subepicardial hemorrhage and interstitial edema and hemorrhages on histologic samples from regions of the myocardium outside the infarction itself and also from the right ventricle. These lesions were concluded to be a myocardial contusion. The true incidence of myocardial contusion as a consequence of mechanical chest compressions is not known. We speculate that severe myocardial contusion might have influenced outcome of our patient.
- Publication type
- Journal Article MeSH
Přestože náhlá zástava oběhu postihuje v Evropě přibližně půl miliónu osob ročně, výsledky její léčby nejsou dlouhodobě uspokojivé. V textu jsou shrnuty hlavní změny v nových doporučených postupech pro neodkladnou resuscitaci, které zveřejnila Evropská rada pro resuscitaci v říjnu 2010. Změny v nových doporučeních vycházejí z důkladného přehodnocení nových vědeckých poznatků v oblasti resuscitační medicíny a snahy o zjednodušení stávajících Guidelines 2005. Nejdůležitějším postupem základní i rozšířené nedokladné resuscitace zůstává nadále kvalitní nepřímá srdeční masáž. Komprese hrudníku musí být prováděny rázně do hloubky alespoň 5 centimetrů a frekvencí nejméně 100krát za minutu. Velký důraz je kladen na častější používání automatizovaných externích defibrilátorů a zvýšení dostupnosti přístrojů k provedení časné defibrilace. V rozšířené neodkladné resuscitaci bylo provedeno několik změn. Nadále již není doporučena intratracheální aplikace léků ani podání atropinu v algoritmu asystolie, větší důraz je kladen na léčbu syndromu po srdeční zástavě, byly prokázány nežádoucí účinky hyperoxie. Srdeční masáž, časná defibrilace a časná terapeutická hypotermie patří mezi nejdůležitější postupy kardiopulmonální resuscitace s příznivým vlivem na klinický výsledek.
About 500,000 people suffer a sudden cardiac arrest in Europe every year but their treatment has not been satisfactory for years. The main issues in the Guidelines for cardiopulmonary resuscitation launched by the European Resuscitation Council in October 2010 are summarized in the article. The changes in the new recommendations are based on recent scientific evidence in resuscitation medicine and an effort to make them simpler compared to the last 2005 Guidelines. Chest compression remains the most important action in both basic and advanced life support. The victim’s chest must be pushed hard into the depth of at least 5 centimetres with a frequency of at least 100 per minute. Higher employment of automated external defibrillators and better availability of devices to deliver early defibrillation are encouraged. Some steps in the advanced life support algorithm have also changed. Neither tracheal administration of drugs nor atropine in asystole have been recommended, a treatment of the post-cardiac arrest syndrome has been emphasized, and the adverse effects of hyperoxia have been proven. Chest compressions, early defibrillation, and early therapeutic hypothermia are the key procedures of cardiopulmonary resuscitation affecting favourable outcome.
- Keywords
- Evropská rada pro resuscitaci, léčba, rozšířená neodkladná resuscitace, základní neodkladná resuscitace,
- MeSH
- Defibrillators utilization MeSH
- Child MeSH
- Adult MeSH
- Electric Countershock methods instrumentation utilization MeSH
- Financing, Organized MeSH
- Cardiopulmonary Resuscitation methods standards education MeSH
- Middle Aged MeSH
- Humans MeSH
- Heart Massage methods standards trends MeSH
- Death, Sudden, Cardiac MeSH
- Reperfusion Injury etiology MeSH
- Life Support Care methods trends MeSH
- Resuscitation Orders MeSH
- Aged MeSH
- Practice Guidelines as Topic standards MeSH
- Syndrome MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Publication type
- Review MeSH
Změny v nových doporučeních vycházejí z důkladného přehodnocení nových vědeckých poznatků v oblasti resuscitační medicíny a snahy o zjednodušení stávajících Guidelines 2005. Nejdůležitějším postupem základní i rozšířené neodkladné resuscitace zůstává nadále kvalitní nepřímá srdeční masáž. Komprese hrudníku musí být prováděny rázně do hloubky alespoň 5 centimetrů a frekvencí nejméně 100krát za minutu. Velký důraz je kladen na častější používání automatizovaných externích defibrilátorů a zvýšení dostupnosti přístrojů k provedení časné defibrilace. V rozšířené neodkladné resuscitaci bylo provedeno několik změn. Nadále již není doporučena intratracheální aplikace léků ani podání atropinu v algoritmu asystolie, větší důraz je kladen na léčbu syndromu po srdeční zástavě. Srdeční masáž, časná defibrilace a časná terapeutická hypotermie patří mezi nejdůležitější postupy kardiopulmonální resuscitace s příznivým vlivem na klinický výsledek.
The changes in the new recommendations are based on recent scientific evidence in resuscitation medicine and an effort to make them simpler compared to the last 2005 Guidelines. Chest compression remains the most important action in both basic and advanced life support. The victim s chest must be pushed hard into the depth of at least 5 centimetres with a frequency of at least 100 per minute. Higher employment of automated external defibrillators and better availability of devices to deliver early defibrillation are encouraged. Some steps in the advanced life support algorithm have also changed. Neither tracheal administration of drugs nor atropine in asystole have been recommended, a treatment of the post-cardiac arrest syndrome has been emphasized. Chest compressions, early defibrillation, and early therapeutic hypotermia are the key procedures of cardiopulmonary resuscitation affecting favourable outcome.
- MeSH
- Cardiopulmonary Resuscitation * methods standards trends MeSH
- Humans MeSH
- Practice Guidelines as Topic * MeSH
- Emergency Medicine methods standards trends MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
V súčasnej dobe s vyspelou technologickou úrovňou je veľmi podstatné šíriť osvetu o manipulácií s automatickým externým defibrilátorom (AED) a nevyhnutné je taktiež i prístroje AED rozmiestňovať medzi laickú verejnosť. Podstatná je edukácia širokej verejnosti o jednoduchosti a bezpečnosti použitia prístrojov pri náhlom zastavení krvného obehu. Telefonicky asistovaná neodkladná resuscitácia zvyšuje počet zahájených kardiopulmonálnych resuscitácií a skracuje čas do ich zahájenia. Taktiež zvyšuje počet prevedených kompresií hrudníka a zlepšuje prognózu pacienta a výsledky liečby prednemocničného zastavenia krvného obehu. Krajské operačné strediská záchrannej zdravotnej služby by mali poskytovať záchrancom podporu operátorom vo všetkých prípadoch predpokladaného zastavenia srdca s výnimkou situácie, keď vyškolený záchranca už kardiopulmonálnu resuscitáciu zahájil. V Slovenskej republike aktuálne evidujeme v registri Operačného strediska záchrannej zdravotnej služby Slovenskej republiky viac ako 2500 prístrojov AED.
In today’s advanced technological level, it is very important to spread awareness about handling automatic external defibrillator (AED) and it is also necessary to distribute AED devices among the lay public. It is essential to educate the general public about the ease and safety of using devices in the event of a sudden stoppage of blood circulation. Telephone-assisted emergency resuscitation increases the number of initiated cardiopulmonary resuscitations and shortens the time until they are initiated. It also increases the number of performed chest compressions and improves the patient’s prognosis and treatment outcomes for pre-hospital circulatory arrest. The regional operational centers of the emergency medical service should provide rescuers with support to operators in all cases of suspected cardiac arrest, with the exception of the situation when a trained rescuer has already started cardiopulmonary resuscitation. In the Slovak Republic, we currently register more than 2,500 AED devices in the register of the Operation Center of the Emergency Medical Service of the Slovak Republic.
Úvod: Moderní optoelektronické metody se využívají k přesnému měření povrchu objektů v různých odvětvích. S využitím těchto zkušeností byl sestrojen optoelektronický skener BS04, který bezkontaktně měří povrch lidského těla. Cíl: Hlavním cílem studie bylo ověření proveditelnosti a vhodnosti přístroje BS04 pro použití ve zdravotnictví a porovnání rozdílů v měření antropometrických rozměrů dolních končetin mezi optoelektronickou metodou a ručním měřením. Metodika: Nejprve proběhla pilotní studie, která ověřila postup měření rozměrů dolních končetin pomocí BS04. Poté bylo provedeno celkem 72 sérií opakovaného přístrojového měření a 144 sérií opakovaného ručního měření u 24 dobrovolníků ve 14 měřících bodech na dolních končetinách. Ke srovnání výsledků byl použit párový t-test pro hodnoty diferencí. Statistické testy byly hodnoceny na hladině významnosti 5 %. Výsledky: Při porovnání metod byl ve všech případech zjištěn statisticky významný rozdíl. Průměrná diference ručního a přístrojového měření se pohybovala v rozmezí od –3,20 do –0,47 cm (min. –6,58 cm, max. 0,78 cm). Přístrojové měření podávalo v průměru vyšší hodnoty oproti ručnímu. Byly zjištěny určité limitace, které brání prozatímnímu maximálnímu využití přístroje BS04 pro celou šíři populace, především imobilní jedince. Závěr: Obrovská perspektiva využití tohoto přístroje spočívá v prevenci a v časném záchytu počínajících otoků z různých příčin, dále také v diferenciální diagnostice a léčbě otoků dolních končetin z příčin žilní nedostatečnosti, lymfatických poruch mízních cév dolních končetin či poruch tukového metabolismu. V neposlední řadě má tento přístroj potenciálně velký význam při konstrukci ortopedických, kompresních i jiných léčebných zdravotních pomůcek. Z tohoto hlediska by přesné hodnoty naměřené přístrojem umožnily konstrukci pomůcek s adekvátní mírnou kompresí i například pro diabetické pacienty.
Background: Modern optoelectronic methods are used in various sectors to precisely measure surface areas of objects. Building on previous experiences, the BS04 optoelectronic scanner has been constructed for contactless measurements of the human body surface area. Objective: The main objective of the study was to verify the feasibility and suitability of the BS04 for use in healthcare and to compare differences in the measurement of the antropometric dimensions of the lower limbs extremities the optoelectronic method and the manual measurement. Methods: First, a pilot study was carried out to verify the procedure of measurement of the lower extremities dimensions using BS04. Then, a total of 72 series of repeated automated and 144 series of repeated manual measurements were performed in 24 volunteers at 14 measurement points located on the lower extremities. A pairwise t-test for difference values was used to compare the results. Statistical significance was assessed at 5% level. Results: The comparison showed statistically significant differences in all cases. The mean difference between ranges from –3.20 to –0.47 cm (min. –6.58 cm, max. 0.78 cm). On average, the values obtained by BS04 were higher than by manual measurements. Certain limitations were found that, for the time being, prevent full use of the BS04 in the entire population, particularly immobile individuals. Conclusions: A huge prospect of using this device lies in the prevention and early detection of onset swelling of various causes, also in differential diagnosis and treatment of lower limb swelling due to venous insufficiency, lymphatic disorders of the lower limb vascular vessels or disorders of fat metabolism. Last but not least, this device is potentially of great importance in the design of orthopedic, compressible and other therapeutic medical devices. From this point of view, the exact values measured by the BS04 would allow the construction of medical aids with adequate mild compression even for diabetic patients.
BACKGROUND: Advanced Life Support (ALS) during cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) is frequently administered by two-member crews. However, ALS CPR is mostly designed for larger crews, and the feasibility and efficacy of implementing ALS guidelines for only two rescuers remain unclear. OBJECTIVE: This scoping review aims to examine the existing evidence and identify knowledge gaps in the efficiency of pre-hospital ALS CPR performed by two-member teams. DESIGN: A comprehensive search was undertaken across the following databases: PubMed, Web of Science, SCOPUS, Cochrane Library Trials, and ClinicalTrials.gov. The search covered publications in English or German from January 1, 2005, to November 30, 2023. The review included studies that focused on ALS CPR procedures carried out by two-member teams in adult patients in either simulated or clinical settings. RESULTS: A total of 22 articles were included in the qualitative synthesis. Seven topics in two-person prehospital ALS/CPR delivery were identified: 1) effect of team configuration on clinical outcome and CPR quality, 2) early airway management and ventilation techniques, 3) mechanical chest compressions, 4) prefilled syringes, 5) additional equipment, 6) adaptation of recommended ALS/CPR protocols, and 7) human factors. CONCLUSION: There is a lack of comprehensive data regarding the adaptation of the recommended ALS algorithm in CPR for two-member crews. Although simulation studies indicate potential benefits arising from the employment of mechanical chest compression devices, prefilled syringes, and automation-assisted protocols, the current evidence is too limited to support specific modifications to existing guidelines.
- Publication type
- Journal Article MeSH
- Review MeSH
Techniky a postupy využívané pri poskytovaní kardiopulmonálnej resuscitácie môžu viesť k vzniku vedľajších poranení. Autori ponúkajú prehľad problematiky poranení asociovaných so zabezpečovaním priechodnosti dýchacích ciest, resuscitáciou dýchania a resuscitáciou obehu. Poranenia sú analyzované v závislosti na type aplikovaných resuscitačných techník - spôsob zaistenia dýchacích ciest, nepriama masáž srdca bez pomôcok, alebo s využitím mechanických resuscitačných prístrojov a defibrilácia.
Introduction: Therapeutic procedures performed during cardiopulmonary resuscitation on patients in cardiac arrest or unconsciousness from any other cause can have serious adverse effects. Scale of injuries scale is very wide – from simple skin lacerations up to serious injuries which can even thwart possibility of successful resuscitation and cause death. Materials and methods: Comprehensive review of current literature aimed at injuries associated with cardiopulmonary resuscitation. Results: Authors of this paper offer up-to-date review of possible cardiopulmonary resuscitation associated injuries, which are discussed depending on the method of performed resuscitation – airway management, chest compressions without tools or with automated mechanical devices, and defibrillation. Airway management is frequently associated with subcutaneous hematomas of the neck and head, mucosal membrane lacerations, teeth fractures and airway aspiration. Autopsy findings after cardiac massage are: rib and sternal fractures (very frequent); pleura, lung and cardiac injuries (frequent); cervical spine injuries, pericardial tamponades due to cardiac or aorta rupture, liver, spleen or stomach lacerations (rare). Defibrillation can create skin burns, cardiac or renal injuries due to rhabdomyolysis. Conclusion: Forensic pathologists as well as clinical practitioners should be aware of the relevance of possible injuries associated with cardiopulmonary resuscitation. The injuries should be avoided if possible, or distinguished from injuries of other origin if they cannot be prevented.
- MeSH
- Rib Fractures etiology MeSH
- Thoracic Cavity injuries MeSH
- Intubation, Intratracheal * adverse effects MeSH
- Cardiopulmonary Resuscitation * methods adverse effects MeSH
- Humans MeSH
- First Aid * adverse effects MeSH
- Respiration, Artificial * adverse effects MeSH
- Airway Management * instrumentation adverse effects MeSH
- Check Tag
- Humans MeSH
- Keywords
- Bobath koncept, senzorická integrace podle Ayresové, Brain port, neurologická rehabilitace,
- MeSH
- Aphasia MeSH
- Amyotrophic Lateral Sclerosis * etiology rehabilitation MeSH
- Unconsciousness rehabilitation MeSH
- Botulinum Toxins, Type A therapeutic use MeSH
- Cerebrovascular Disorders MeSH
- Charcot-Marie-Tooth Disease rehabilitation MeSH
- Polyradiculoneuropathy, Chronic Inflammatory Demyelinating rehabilitation MeSH
- Diabetic Neuropathies etiology rehabilitation MeSH
- Child MeSH
- Dysarthria MeSH
- Friedreich Ataxia MeSH
- Guillain-Barre Syndrome rehabilitation MeSH
- Hereditary Sensory and Motor Neuropathy rehabilitation therapy MeSH
- Intracranial Hemorrhages MeSH
- Brain Ischemia * rehabilitation MeSH
- Channelopathies MeSH
- Cognition Disorders diagnosis rehabilitation MeSH
- Craniocerebral Trauma rehabilitation MeSH
- Humans MeSH
- Cerebral Palsy MeSH
- Myasthenia Gravis rehabilitation MeSH
- Myotonic Disorders MeSH
- Basal Ganglia Diseases MeSH
- Cerebellar Diseases rehabilitation MeSH
- Neurodegenerative Diseases MeSH
- Neuronal Plasticity MeSH
- Neuropsychological Tests MeSH
- Neuropsychology methods MeSH
- Orthopedic Procedures rehabilitation MeSH
- Paresis * rehabilitation MeSH
- Parkinson Disease * etiology rehabilitation MeSH
- Perceptual Disorders rehabilitation MeSH
- Persistent Vegetative State MeSH
- Polyneuropathies * rehabilitation MeSH
- Spinal Cord Injuries * complications rehabilitation MeSH
- Brain Injuries rehabilitation MeSH
- Peripheral Nerve Injuries rehabilitation MeSH
- Deglutition Disorders MeSH
- Sensation Disorders rehabilitation MeSH
- Postpoliomyelitis Syndrome MeSH
- Postural Balance MeSH
- Orthotic Devices * MeSH
- Rhizotomy MeSH
- Multiple Sclerosis * etiology rehabilitation MeSH
- Spinocerebellar Ataxias MeSH
- Muscular Dystrophies rehabilitation MeSH
- Nerve Compression Syndromes * rehabilitation MeSH
- Vertigo diagnosis rehabilitation MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Keywords
- Bobath koncept, senzorická integrace podle Ayresové, Brain port, neurologická rehabilitace,
- MeSH
- Aphasia MeSH
- Amyotrophic Lateral Sclerosis * etiology rehabilitation MeSH
- Unconsciousness rehabilitation MeSH
- Botulinum Toxins, Type A therapeutic use MeSH
- Cerebrovascular Disorders MeSH
- Charcot-Marie-Tooth Disease rehabilitation MeSH
- Polyradiculoneuropathy, Chronic Inflammatory Demyelinating rehabilitation MeSH
- Diabetic Neuropathies etiology rehabilitation MeSH
- Child MeSH
- Dysarthria MeSH
- Friedreich Ataxia MeSH
- Guillain-Barre Syndrome rehabilitation MeSH
- Hereditary Sensory and Motor Neuropathy rehabilitation therapy MeSH
- Intracranial Hemorrhages MeSH
- Brain Ischemia * rehabilitation MeSH
- Channelopathies MeSH
- Cognition Disorders diagnosis rehabilitation MeSH
- Craniocerebral Trauma rehabilitation MeSH
- Humans MeSH
- Cerebral Palsy MeSH
- Myasthenia Gravis rehabilitation MeSH
- Myotonic Disorders MeSH
- Basal Ganglia Diseases MeSH
- Cerebellar Diseases rehabilitation MeSH
- Neurodegenerative Diseases MeSH
- Neuronal Plasticity MeSH
- Neuropsychological Tests MeSH
- Neuropsychology methods MeSH
- Orthopedic Procedures rehabilitation MeSH
- Paresis * rehabilitation MeSH
- Parkinson Disease * etiology rehabilitation MeSH
- Perceptual Disorders rehabilitation MeSH
- Persistent Vegetative State MeSH
- Polyneuropathies * rehabilitation MeSH
- Spinal Cord Injuries * complications rehabilitation MeSH
- Brain Injuries rehabilitation MeSH
- Peripheral Nerve Injuries rehabilitation MeSH
- Deglutition Disorders MeSH
- Sensation Disorders rehabilitation MeSH
- Postpoliomyelitis Syndrome MeSH
- Postural Balance MeSH
- Orthotic Devices * MeSH
- Rhizotomy MeSH
- Multiple Sclerosis * etiology rehabilitation MeSH
- Spinocerebellar Ataxias MeSH
- Muscular Dystrophies rehabilitation MeSH
- Nerve Compression Syndromes * rehabilitation MeSH
- Vertigo diagnosis rehabilitation MeSH
- Check Tag
- Child MeSH
- Humans MeSH
