Lege Artis Medicinae

[The resuscitation of CPR]

MATOS Lajos

NOVEMBER 20, 2007

Lege Artis Medicinae - 2007;17(11)

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[I want to examine the medical ethical and legal issues of organ transplantation practice in Hungary from the clinician's 1 . perspective. The development of diagnostic and therapeutic methods, resuscitation procedures, and the everyday practice of organ transplantation repeatedly place the physician in a situation in which medical ethical, legal and social traditions come into conflict with the physician's professional experience, conscience and scientific aspirations. Organ transplantation is an area of medicine that has recently generated much controversy. In our country, this is partly because it is no longer an experimental procedure: there is a growing need for more and more transplantable donor organs, one of the conditions for which is the cooperation between the doctor and civil society. ]

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[In sudden cardiac arrest situations laypeople are important parts of the chain of survival. The aim of the study: Our aim was to compare different resuscitation education methods and to measure the effectiveness of video-supported method among primary school children. In our study participants were 10-15 years old primary school children (N=147). There were made a pre-test and two post-tests (1 and 4 months later). Data collection was made by a self-fill-in questionnaire and a practical test with a BLS manikin. There were made three groups: the FRONTAL group was teached with traditional methods; the VIDEO group was teached by a 5-minutes long, self made video; the PHANTOM group was teached by the video and a self-made manikin. Based on the tests the FRONTAL group performed the highest scores (p<0.001). However, the best performance in the depth of the chest compression scored the PHANTOM group (p<0.001). The frequency of the chest compressions was the best in the FRONTAL group (p=0.01). Body weight >50 kg (p=0.042) and age >12 years (p<0.001) associated with significantly deeper chest compressions. In our study, the traditional method was the most effective. However, using a video the results can be similar.]

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[The significance of post-reanimation treatment using therapeutic hypothermia in the intensive care ward]

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[Aim of the research: To assess the significance of applying therapeutic hypothermia (TH) in order to prevent cerebral neurologic damage following cardiopulmonary resuscitation (CPR). Research and sampling methods: Retrospective and quantitative research, applying stratified, not random sampling. The research was conducted by analysing medical and clinical nurse documentation, using direct data collection. The total number of patients (n) referred to the intensive care ward of county hospital due to prolonged life support (PLS) during the two different years was 68. In 2005, the number of patients (n) not receiving TH was 28 whereas in 2010 the number of patients who did receive TH was 29 and the number of those who did not receive TH in the same year was 11. Results: Comparing the research results of the two patient groups, it can be concluded that the patients who received TH in 2010 left the intensive care ward with better neurological function, no significant difference. PLS carried out with full body cooling proved to be more effective by decreasing hypoxic damage in the brain tissue, in consequence of which better neurological results are expectable. Conclusion: the application of TH is necessary following CPRs when the patient remains unconscious even after regaining spontaneous circulation. In everyday practice of intensive care wards, TH should be applied as per standard protocol. All clinical nurse staff should be aware of the cooling techniques and of the use the necessary medical equipment. Practical application and the earliest possible start of TH can be done more effectively by improving the nurses’ relevant knowledge, providing higher financial support and expanding the circle of medical equipment. ]

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