RESUMEN
Previous investigations from densely populated areas have shown that more patients with prehospital circulatory arrest caused by ischemic heart disease can be successfully treated by strengthening a chain of survival. This chain consists of immediate alarm followed by prompt cardiopulmonary resuscitation, early defibrillation and advanced medical support before transportation to hospital. This paper describes the methods used in the training of lay people in cardiopulmonary resuscitation, as well as how ambulance personnel were trained to use a semiautomatic defibrillator. During the period 1987-89 11.7% of the inhabitants in Nord-Gudbrandsdal attended a course in heart lung resuscitation and all the ambulance personnel were trained and certified to use Heartstart 2000 semiautomatic defibrillators.
Asunto(s)
Técnicos Medios en Salud/educación , Reanimación Cardiopulmonar , Enfermedad Coronaria/terapia , Servicios Médicos de Urgencia , Paro Cardíaco/terapia , Choque/terapia , Ambulancias , Reanimación Cardiopulmonar/métodos , Enfermedad Coronaria/mortalidad , Cardioversión Eléctrica/métodos , Servicios Médicos de Urgencia/economía , Paro Cardíaco/mortalidad , Humanos , Noruega , Población Rural/estadística & datos numéricos , Choque/mortalidad , Recursos HumanosRESUMEN
In Project Nord-Gudbrandsdal we aimed to reduce prehospital mortality from myocardial infarction in a sparsely populated area. The ambulance system consisted of local ambulances with semi-automatic defibrillators (the ambulance personnel were trained in the use of these), combined with advanced medical support from the local doctor and/or the air ambulance doctor. During the three-year period (1987-89) 75 prehospital cardiac arrests were observed in a population of 22,000 inhabitants. 12 patients with ventricular fibrillation were defibrillated, and eight primarily with success. Four patients were discharged from hospital in a satisfactory condition. We discuss the factors determining successful resuscitation.
Asunto(s)
Reanimación Cardiopulmonar/métodos , Cardioversión Eléctrica/métodos , Servicios Médicos de Urgencia , Paro Cardíaco/terapia , Infarto del Miocardio/terapia , Choque/terapia , Adulto , Anciano , Técnicos Medios en Salud/educación , Ambulancias , Servicios Médicos de Urgencia/estadística & datos numéricos , Femenino , Paro Cardíaco/diagnóstico , Paro Cardíaco/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Noruega/epidemiología , Población Rural/estadística & datos numéricos , Choque/mortalidad , Resultado del Tratamiento , Recursos HumanosRESUMEN
51 dual lumen jugularis dialysis catheters (Permcath, Quinton) were placed by surgical technique in 34 patients and by percutaneous technique in eight patients. Mean catheter life-time was 4.1 months. Seven catheters were removed due to complications (infection three catheters, clotting four catheters). Minor flow problems occurred in 8.8% of all procedures. Seven occluded catheters were successfully reopened by use of locally applied streptokinase. A strict aseptic technique is essential to avoid infection. Permcath is an acceptable vascular access device for patients in whom it is impossible to create an arterio-venous fistula.