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Breakthrough in cardiac arrest: reports from the 4th Paris International Conference

9/22/2015

Ann Intensive Care. 2015 Dec;5(1):22.

The French Intensive Care Society organized on 5th and 6th June 2014 its 4th “Paris International Conference in Intensive Care”, whose principle is to bring together the best international experts on a hot topic in critical care medicine. The 2014 theme was “Breakthrough in cardiac arrest”, with many high-quality updates on epidemiology, public health data, pre-hospital and in-ICU cares. The present review includes short summaries of the major presentations, classified into six main chapters:

Epidemiology of CA
Pre-hospital management
Post-resuscitation management: targeted temperature management
Post-resuscitation management: optimizing organ perfusion and metabolic parameters
Neurological assessment of brain damages
Public healthcare

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Modeling Evacuation of a Hospital without Electric Power

9/10/2015

Prehospital and Disaster Medicine;30(3):June 2015:279-287

Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital’s primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital’s ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model’s ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing.

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Anaesthetist-provided pre-hospital advanced airway management in children: a descriptive study

9/3/2015

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2015, 23:61

Background
Pre-hospital advanced airway management has been named one of the top-five research priorities in physician-provided pre-hospital critical care. Few studies have been made on paediatric pre-hospital advanced airway management. The aim of this study was to investigate pre-hospital endotracheal intubation success rate in children, first-pass success rates and complications related to pre-hospital advanced airway management in patients younger than 16 years of age treated by pre-hospital critical care teams in the Central Denmark Region (1.3 million inhabitants).

Methods
A prospective descriptive study based on data collected from eight anaesthetist-staffed pre-hospital critical care teams between February 1st 2011 and November 1st 2012. Primary endpoints were 1) pre-hospital endotracheal intubation success rate in children 2) pre-hospital endotracheal intubation first-pass success rate in children and 3) complications related to prehospital advanced airway management in children.

Results
The pre-hospital critical care anaesthetists attempted endotracheal intubation in 25 children, 13 of which were less than 2 years old. In one patient, a neonate (600 g birth weight), endotracheal intubation failed. The patient was managed by uneventful bag-mask ventilation. All other 24 children had their tracheas successfully intubated by the pre-hospital critical care anaesthetists resulting in a pre-hospital endotracheal intubation success rate of 96 %. Overall first pass success-rate was 75 %. In the group of patients younger than 2 years old, first pass success-rate was 54 %. The total rate of airway management related complications such as vomiting, aspiration, accidental intubation of the oesophagus or right main stem bronchus, hypoxia (oxygen saturation < 90 %) or bradycardia (according to age) was 20 % in children younger than 16 years of age and 38 % in children younger than 2 years of age. No deaths, cardiac arrests or severe bradycardia (heart rate <60) occurred in relation to pre-hospital advanced airway management.

Conclusion
Compared with the total population of patients receiving pre-hospital advanced airway management in our system, the overall success rate following pre-hospital endotracheal intubations in children is acceptable but the first-pass success rate is low. The complication rates in the paediatric population are higher than in our pre-hospital advanced airway management patient population as a whole. This illustrates that young children may represent a substantial pre-hospital airway management challenge even for experienced pre-hospital critical care anaesthetists. This may influence future training and quality insurance initiatives in paediatric pre-hospital advanced airway management.

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Breakthrough in cardiac arrest: reports from the 4th Paris International Conference

Ann Intensive Care. 2015 Dec;5(1):22.

Modeling Evacuation of a Hospital without Electric Power

Anaesthetist-provided pre-hospital advanced airway management in children: a descriptive study

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Anesthesiologie - Urgentiegeneeskunde
www.urgentiegeneeskunde.com

de gratis online resource over trauma-anesthesie, reanimatie, resuscitatie, airway management, prehospitale zorg en alles wat te maken heeft met de zorg voor de vitaal bedreigde patient.

Breakthrough in cardiac arrest: reports from the 4th Paris International Conference

Ann Intensive Care. 2015 Dec;5(1):22.

Modeling Evacuation of a Hospital without Electric Power

Anaesthetist-provided pre-hospital advanced airway management in children: a descriptive study

Categories

Archives

Anesthesiologie - Urgentiegeneeskundewww.urgentiegeneeskunde.comde gratis online resource over trauma-anesthesie, reanimatie, resuscitatie, airway management, prehospitale zorg en alles wat te maken heeft met de zorg voor de vitaal bedreigde patient.

Anesthesiologie - Urgentiegeneeskunde
www.urgentiegeneeskunde.com

de gratis online resource over trauma-anesthesie, reanimatie, resuscitatie, airway management, prehospitale zorg en alles wat te maken heeft met de zorg voor de vitaal bedreigde patient.