Knowledge in airway management during cardio pulmonary resuscitation

International Guidelines recommend that all health professionals should be able to face a cardiac arrest applying CPR . Knowledge and experience in maintaining patency of the airway and cardiopulmonary resuscitation is one of the most basic tasks and provided him administering sedation analgesia . But in our country , education of medical students in maintaining patency of the airway and resuscitation, as well as continuous training of Doctors in various specialties, follows several educational systems, according to the School or clinic curriculum and on the goals of each physician for high specificity. This results in significant variation in clinical training and clinical skills of each doctor.Διεθνείς Κατευθυντήριες οδηγίες συστήνουν ότι όλοι οι επαγγελματίες υγείας θα πρέπει να είναι ικανοί να αντιμετωπίζουν μια ανακοπή εφαρμόζοντας καρδιοαναπνευστική αναζωογόνηση. Η γνώση και η εμπειρία στη διατήρηση βατότητας του αεραγωγού και στην καρδιοπνευμονική αναζωογόνηση αποτελεί ένα από τα πιο βασικά καθήκοντα και προϋπόθεση γι’ αυτόν που χορηγεί αναλγησία καταστολή. Ωστόσο στη χώρα μας, η εκπαίδευση των φοιτητών Ιατρικής στη διατήρηση βατότητας αεραγωγού και στην αναζωογόνηση, όπως επίσης και η συνεχής εκπαίδευση των Ιατρών διαφόρων ειδικοτήτων ακολουθεί διαφορετικά συστήματα που καθορίζονται από το εκάστοτε πρόγραμμα σπουδών της Σχολής ή Κλινικής και από τους στόχους του εκάστοτε ιατρού για υψηλή εξειδίκευση, με αποτέλεσμα η κλινική εκπαίδευση σ’ αυτές και οι κλινικές δεξιότητες των γιατρών να διαφοροποιούνται σημαντικά

Bacterial translocation induces proinflammatory responses and is associated with early death in experimental severe injury

Objective: An experimental model of severe injury with great lethality was studied to define the impact of bacterial translocation on survival and on inflammatory response. Methods: Forty-one rabbits were divided into two groups: A, femur myotomy; and B, myotomy and fracture of the femoral bone. Vital signs and survival were recorded. Serum circulating endotoxins (lipopolysaccharides; LPS) were determined and tissue cultures were performed at necropsy. A subgroup of animals was sacrificed at 48 h post injury; LPS was determined in abdominal aorta and portal vein, apoptosis of spleen cells was assessed by flow cytometry, and ex vivo production of tumor necrosis factor alpha by splenocytes was measured. Results: Tissue bacterial burden was increased in animals that died early (i.e., within 48 h after injury) versus rabbits that died later. Portal vein LPS at 48 h was increased in group B compared with group A, whereas circulating LPS did not differ. No difference in apoptosis of either lymphocytes or macrophages of the spleen was found in group B compared with group A. Following stimulation with LPS or phytohemagglutinin, tumor necrosis factor a production by splenocytes of group B was greater than that of group A. Conclusions: Bacterial translocation primes enhanced proinflammatory responses and it is associated with early death in severe trauma. (C) 2013 Elsevier Inc. All rights reserved