Archive for the ‘research’ Category
Supportve care for asthma attacks
In addition to beta agonists, steroids, epi, mag, etc, etc in treatment of asthma, you might also consider coaching your patients to breathe slower.
Eurekalert has a study from Southern Methodist University showing that asthma patients who were taught to slow their breathing during an attack can decrease the severity of attacks.
During an attack, sufferers tend to hyperventilate, breathing fast and deep against constricted airways to fight an overwhelming feeling of oxygen deprivation.
Unfortunately, this makes the problem worse by lowering the body’s carbon dioxide levels, which restricts blood flow to the brain and can further irritate already hypersensitive bronchial passages.
Patients who “overbreathe” on a sustained basis risk chronic CO2 deficiencies that make them even more vulnerable to future attacks. Rescue medications that relieve asthma symptoms do nothing to correct breathing difficulties associated with hyperventilation.
Myth, religion, and fact
Rogue Medic has a good post on EMS Mythology that will get your brain going.
We ought to go forward each day realizing that EMS as a profession has only been around for 30 years or so. Where do you suppose Doctors or Lawyers were 30 years into “Doctoring” and Lawyering”?
There’s a lot of work to be done, most of it we haven’t even identified yet. Some places are way ahead of the US.
The Bee Gees do CPR
I dare you to try this on a scene:
“A small study by University of Illinois College of Medicine researchers in Peoria has found that 10 doctors and five medical students who listened to the “Saturday Night Fever” tune while practicing CPR not only performed perfectly, they remembered the technique five weeks later.”
Sadly, there are no videos (yet) of people doing CPR to Stayin’ Alive. Instead, here’s the original music video for the song:
I’ll keep clearing the patient for now…
http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.107.763011v1?papetoc
Submitted on December 27, 2007, Accepted on February 20, 2008, Published Online on May 5, 2008
Hands-On Defibrillation. An Analysis of Electrical Current Flow Through Rescuers in Direct Contact With Patients During Biphasic External Defibrillation
Michael S. Lloyd MD*, Brian Heeke BS, Paul F. Walter MD, and Jonathan J. Langberg MD
From Emory University Hospital, Atlanta, Ga.
Background-Brief interruptions in chest compressions reduce the efficacy of resuscitation from cardiac arrest. Interruptions of this type are inevitable during hands-off periods for shock delivery to treat ventricular tachyarrhythmias. The safety of a rescuer remaining in contact with a patient being shocked with modern defibrillation equipment has not been investigated.
Methods and Results-This study measured the leakage voltage and current through mock rescuers while they were compressing the chests of 43 patients receiving external biphasic shocks. During the shock, the rescuer’s gloved hand was pressed onto the skin of the patient’s anterior chest. To simulate the worst case of an inadvertent return current pathway, a skin electrode on the rescuers thigh was connected to an electrode on the patient’s shoulder. In no cases were shocks perceptible to the rescuer. Peak potential differences between the rescuer’s wrist and thigh ranged from 0.28 to 14 V (mean 5.8±5.8 V). The average leakage current flowing through the rescuer’s body for each phase of the shock waveform was 283±140 µA (range 18.9 to 907 µA). This was below several recommended safety standards for leakage current.
Conclusions-Rescuers performing chest compressions during biphasic external defibrillation are exposed to low levels of leakage current. The present findings support the feasibility of uninterrupted chest compressions during shock delivery, which may enhance the efficacy of defibrillation and cardiocerebral resuscitation.
Diana Neubecker, RN,BSN,EMT-P
EMS System In-Field Coordinator
NWC EMSS, Arlington Heights, IL
