SURVIVAL AFTER PROFOUND PREHOSPITAL SHOCK

A prospective observational study from Paris reports the clinical features and mortality of patients with profound prehospital shock (

) . Patients presenting with severe hypotension (non-palpable pulse and unrecordable blood pressure) in the prehospital setting had a subsequent overall mortality of 50%. Most of the deaths occurred after arrival at hospital. Unsurprisingly, prehospital cardiac arrest, age and co-existing chronic disease were associated with poor outcomes. Survival was not associated with the type of illness causing the hypotension, but a rapid favourable response to prehospital resuscitation correlated with a good outcome.

A NEW DEVICE FOR CPR

Good quality chest compressions are an essential part of cardiopulmonary resuscitation, and there seems to be no end to the methods being devised to deliver them. The latest device to be reported is the ‘lifebelt’ (

) . It combines manual sternal compressions with thoracic constraint. A randomised trial involving 42 anaesthetised swine resulted in better coronary perfusion pressures and a higher rate of return of spontaneous circulation with the lifebelt after VF was induced and then treated.

CAN SUTURES GET WET?

Traditional teaching demands that recently sutured wounds be kept covered …