摘要:

&NA;Health care facilities should reassess their resuscitation team response strategies in light of the shift in care from inpatient to outpatient facilities. This article discusses a strategy for assessing a health care facility's resuscitation needs globally, including a detailed analysis of the physical layout, population requiring coverage, personnel, and equipment. Resuscitation system design is reviewed, with particular emphasis on training, equipment, process variables, administration, cost, and quality improvement. Widespread training of nurse‐first responders in the use of automated external defibrillators along with an in‐hospital or community emergency medical services advanced life‐support response is a cost‐effective way of providing tiered coverage to remote outpatient facilities or satellite units.

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;In the TACTICS‐TIMI‐18 trial, patients with acute coronary syndrome were treated with aspirin, heparin, and tirofiban and were randomized to an invasive strategy with routine catheterization or to a conservative strategy with catheterization (only if the patient had objective evidence of ischemia). Eighty‐two of 2,220 patients were treated in 13 peripheral hospitals without an onsite catheterization laboratory. Tirofiban was administered to the peripheral hospital group (which was treated invasively) for 28.4 hours before coronary angiography, compared with 20.6 hours in the tertiary center group (P= 0.01). There is a similar trend in outcomes with benefit of invasive therapy among patients treated in peripheral and tertiary hospitals, without increase risk of major bleeding.

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;We analyzed performance of a ventricle‐paced, ventricle‐sensed, inhibited, rate‐responsive (VVIR) pacemaker driven by autonomic nervous system activity sensor in chagasic patients with cardiac conduction system disturbances. Forty‐seven chagasic patients were studied (28 male, 19 female; age, 24‐68 years). Thirty‐six patients had complete atrioventricular (AV) block, eight had second‐degree AV block, and the remaining three patients had sinus node disease. Patients were divided into two groups according to their heart rate (HR) at rest: group 1 had an HR more than 65 bpm; group 2, HR less than 65 bpm. A comparative study that extended over the first 12 months after pacemaker implantation evaluated: HR at rest and during various types of stress tests, arterial blood pressure at rest and during exercise, and performance of the TIR‐60 UP leads in conjunction with the sensor function as compared with the performance of other leads. Patients from group 1 had a higher HR at rest and a smaller HR variation during stress test than did patients from group 2. This indicates that with this type of rate‐adaptive system it is possible to control each patient individually. The blood pressure at rest and during stress tests did not differ between the two patient groups. With respect to the sensor function, the TIR‐60 UP leads offered the same performance as others leads. The VVIR pacemaker equipped with the sensor of autonomic nervous system activity allowed chagasic patients to restore their physiologic mechanisms. Seventy‐four percent of the patients had the New York Heart Association Functional Class improved by 1 or 2 steps, after the pacemaker implantation.

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1535-282X    

出版商:OVID    

年代:2002

数据来源: OVID