La presente publicación "Aspectos destacados de las guías" resume las principales cuestiones y cambios de las Guías de la American Heart Association (AHA) de 2010 para reanimación cardiopulmonar (RCP) y atención cardiovascular de emergencia (ACE). Se ha desarrollado con el objetivo de que los proveedores de reanimación y los instructores de la AHA se enfoquen en la ciencia y en las recomendaciones que son más importantes, las que fueron más discutidas o las que resultarán en cambios en la aplicación de la reanimación o en el modo de entrenarse para ello. Además, se ofrecen los fundamentos de dichas recomendaciones.
Auditoría de la seguridad y la eficacia de la ketamina para la sedación de procedimientos en el servicio de urgencias
Audit of the safety and effectiveness of ketamine for procedural sedation in the emergency department J M Vardy, N Dignon, N Mukherjee, D M Sami, G Balachandran, S Taylor. Emerg Med J 2008;25:579-582 doi:10.1136/emj.2007.056200
Abstract Aim: To examine the effectiveness and safety of the sedative agents used in the emergency department following the introduction of ketamine as an agent for procedural sedation. Methods: A 2-year prospective audit of sedation practice was undertaken. This specifically examined the rationale behind a doctor's choice of sedative agent, the depth of sedation achieved, adverse events and the time taken to regain full orientation. Results: 210 patients were included of whom 85 (40%) were given ketamine, 107 (51%) midazolam and 18 (9%) propofol. The median time to full orientation was 25 min for ketamine, 30 min for midazolam and 10 min for propofol. Complications occurred in 15.9% of sedations overall (14.6% of those given ketamine, 15.8% given midazolam and 22.2% given propofol). Apnoea and hypoxia most often occurred with midazolam and propofol, while hypertension and hypertonicity were encountered more frequently with ketamine. In addition, 19.5% of patients given ketamine suffered the re-emergence phenomenon. The association between deep sedation with no response to pain and adverse events encountered with midazolam does not occur with ketamine. Conclusions: Ketamine is both safe and effective and compares favourably with midazolam as an agent for procedural sedation in the emergency department. Although the re-emergence phenomenon occurred, no psychological sequelae were encountered after return to full orientation. Ketamine may be particularly useful in groups of patients at high risk of adverse effects with midazolam
Manual of Intensive Care Medicine Publisher: Lippincott Williams and Wilkins | ISBN: 0781799929 | edition 2009 | PDF | 976 pages | 17,9 mb
Completely rewritten and updated for the Fifth Edition, this Spiral Manual remains the leading quick-reference guide to both medical and surgical intensive care. The essential principles, protocols, and techniques from Irwin and Rippe's Intensive Care Medicine, Sixth Edition have been distilled into a portable, practical manual that is ideal for rapid bedside consultation. The user-friendly outline format features numerous tables, illustrations, and annotated references. Highlights of this Fifth Edition include a comprehensive overdoses and poisonings section presented in tabular format, new chapters on minimally invasive monitoring in the ICU, and completely revised cardiology and hematology sections.
He aqui un resumen de las GUIAS DE RESUCITACION CARDIOPULMONAR 2010
ERC Guidelines 2010
The European Resuscitation Council Guidelines for Resuscitation 2010 provide specific instructions for how resuscitation should be practiced and take into account ease of teaching and learning, as well as the science. They were developed by Europeans and have been specifically written with European