VISITAS RECIENTES

AUTISMO TEA PDF

AUTISMO TEA PDF
TRASTORNO ESPECTRO AUTISMO y URGENCIAS PDF

We Support The Free Share of the Medical Information

Enlaces PDF por Temas

Nota Importante

Aunque pueda contener afirmaciones, datos o apuntes procedentes de instituciones o profesionales sanitarios, la información contenida en el blog EMS Solutions International está editada y elaborada por profesionales de la salud. Recomendamos al lector que cualquier duda relacionada con la salud sea consultada con un profesional del ámbito sanitario. by Dr. Ramon REYES, MD

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.
Fuente Ministerio de Interior de España
Mostrando entradas con la etiqueta OXYGEN. Mostrar todas las entradas
Mostrando entradas con la etiqueta OXYGEN. Mostrar todas las entradas

viernes, 23 de agosto de 2024

New OXYMASK tm "One Mask Delivers 24% to 90% Oxygen"


New OXYMASK "One Mask Delivers 24% to 90% Oxygen"

Ideal for EMS, Hospital and Homecare




OxyMask's logical advantages:


  • The only O2 therapy device to deliver FiO2 of 24% - 90%
  • Can be utilized to deliver High Flow O2 therapy to flush
  • Zero probability of creating intrinsic PEEP on flow
    rates > 15 LPM
  • Zero probability of CO2 rebreathing on low flow rates
  • Allows open communication with your patient
  • Designed for nose and mouth breathers
  • Convenient swivel elbow to reposition tubing
  • Naso Gastric tube can be threaded through OxyMask
  • Allows for suctioning & oral care through mask
  • Open mask allows for delivery of other respiratory therapies

Cost saving advantages:

  • Reduces number of O2 devices per patient
  • Simplifies and reduces inventory
  • Reduces PVC waste
  • Reduces manpower due to simple FiO2 / flow changes
  • Reduces medical gas consumption

Proven to Deliver Effective Heliox Therapy

OxyMask O2 % Guidelines


More information in the Link


New OXYMASK "One Mask Delivers 24% to 90% Oxygen"


New OXYMASK "One Mask Delivers 24% to 90% Oxygen"
DO YOU KNOW OXYMASK? https://goo.gl/iwB3ha
New OXYMASK tm "One Mask Delivers 24% to 90% Oxygen"
Cortesía
EMS España / Emergency Medical Services en España

Follow me / INVITA A TUS AMIGOS A SEGUIRNOS
https://www.facebook.com/drramonreyesdiaz/


jueves, 9 de mayo de 2024

GUIA PARA PACIENTES DE OXIGENO DOMICILIARIO by inframedica

Tamaño 4.11 MB
18 Paginas

Enlace para bajar PDF GRATIS 

Post by 

Oxigenoterapia y Vias AEREAS 



MANUAL DE ATENCIÓN AL PARTO EN EL ÁMBITO EXTRAHOSPITALARIO. Ministerio de Sanidad, Servicios Sociales e Igualdad. España



¿Qué es el parto velado "Parto Empelicado" o nacer con bolsa intacta? by NATALBEN.com



Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html
Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html


CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html


Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html


Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html


Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html

Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html
Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html

domingo, 14 de abril de 2024

The dangers of too much O2. EMSWORLD.COM

The dangers of too much O2

More Oxygen Can’t Hurt…Can It?

What have we learned about oxygen? The dangers of too much O2

It was 0635. Larry and Adriane always got to the station early to check out the truck and, if a late call came in, take it so Greg and Chad could get off on time. This was an arrangement the Medic 2 crews shared, and it worked well for them.
As Adriane checked out the D cylinders and M tank, she said offhandedly, “Better be sure we have plenty of Os. We’re due for a chest pain call.” “Watch your mouth,” said Larry, grinning as he tossed her the last of the Twinkies he’d saved. “You know what happens when you say things like that.”
Twenty minutes later they were at the home of Doris, one of their regular patients, a 64-year-old type 2 diabetic who was, in fact, experiencing chest pain she described as 5 on a scale of 0–10.
While Larry attached the 12-lead, Adriane noted the pulse oximeter read 97% on room air, so she put Doris on a non-rebreather mask and turned the oxygen on at 15 liters per minute. “You can’t have enough of this good stuff,” she said. “Let’s get that sat up to 100% for those heart cells.”
After giving an aspirin, starting an IV and giving a squirt of nitroglycerin, they transported Doris to the nearby Level III hospital, where she went immediately to the cath lab, got a stent in her right coronary artery, went to the CCU and eventually returned home three days later, feeling great.
“Good job, folks,” Dr. Chutney said at the chart review the next week, “but here’s something I need to pass along to you: We don’t do 15 liters per minute by non-rebreather for routine chest pain patients anymore.”
“Why?” said Adriane. “In my book it says not to worry about problems from too much oxygen, that they only develop after several days of more than 50% inspired oxygen delivered at higher-than-normal pressures.”
“What book are you reading from, Adriane?” asked Dr. Chutney.
“From my Orange Book,” said Adriane, “Emergency Care and Transportation of the Sick and Injured, seventh edition, from my EMT class back in 2000.”

The Problem

In 2000 that was what we were taught about oxygen therapy for patients with chest pain. But times have changed. We now know that while some oxygen may be good, more is not necessarily better.
We have always known that oxygen is necessary for all animal life, and that lack of oxygen damages tissues. It is beyond argument that patients who are hypoxic must receive supplemental oxygen. What we’ve not always known is that too much oxygen can harm patients in a number of ways.
One is through reactive oxygen species (ROS), often called free radicals. A radical is an atom that has one or more unpaired electrons. Oxygen has two unpaired electrons that make it susceptible to radical formation. When ROS form in cells, damage can occur. Hypoxic cells are greatly susceptible to ROS. These can damage tissues throughout the body, but of particular concern are lung, heart and brain tissues. Not all radicals are bad, and the role of radicals is far beyond the scope of this article, but we know that damage to the plasma membranes, mitochondria and endomembrane systems by ROS is significant.
High oxygen concentrations can also cause atelectasis. Air is about 21% oxygen and 79% nitrogen. The alveoli depend on nitrogen to maintain surfactant production and alveolar patency; when high concentrations of oxygen are administered, oxygen may “wash out” nitrogen and leave the alveoli susceptible to a lack of gas as oxygen diffuses into the blood, causing them to collapse. This “washout” may be desirable temporarily in patients being preoxygenated for rapid- or delayed-sequence intubation, but over time atelectasis may occur, and this is not good. Once intubation is accomplished, a natural mixture of gases must be allowed to reconstitute in the lungs to avoid collapse of alveoli and atelectasis. There is little to be gained by achieving an oxygen pressure of greater than 100 mmHg.

Trauma Patients

 Over the last 20 years we’ve been in the habit of giving high-flow oxygen to just about everybody. Every trauma patient gets oxygen at 15 lpm by non-rebreather mask, regardless of their blood oxygen saturation. What many do not realize is that this was taught not because it was beneficial, but because it was considered an acceptable risk when time limitations necessitated deletion of much of the medical theory during the 1994 revision of the EMT-Basic curriculum. Everyone was taught to deliver high-flow oxygen by non-rebreather without understanding why it was beneficial…or potentially harmful. There is no medical evidence to support this practice unless the patient is hypoxic or in shock.

In 2004, Tulane MDs Zsolt Stockinger and Norman McSwain monitored 5,090 trauma patients not requiring assisted ventilation to see whether supplemental oxygen improved their outcomes. The results showed those who received oxygen did no better or worse than those who did not. The authors concluded supplemental oxygen does not improve survival in traumatized patients who are not in respiratory distress.1

Chest Pain Patients

It has been our traditional practice to give high concentrations of oxygen to patients with chest pain and MI, for reasons no better than “this is how we’ve always done it.” As Israeli physician Chaim Lotan said at a conference in 2011, “We have been brainwashed into using oxygen” even though recent data suggests it has harmful effects that are mediated primarily by coronary artery vasoconstriction. “Before I started looking into the data,” Lotan said, “I didn’t understand how much damage we were causing by giving oxygen.”2
In fact, it is true that 100% oxygen given by non-rebreather reduces coronary artery flow by 30% after 5 minutes. It also reduces the effects of vasodilators such as nitroglycerin.3
This is not exactly a result we’d desire while treating a patient with coronary artery disease. For this reason, the American Heart Association’s emergency cardiac care guidelines have, since 2010, recommended as follows: There is insufficient evidence to support [oxygen’s] routine use in uncomplicated ACS. If the patient is dyspneic, hypoxemic or has obvious signs of heart failure, providers should titrate therapy, based on monitoring of oxyhemoglobin saturation, to ≥94% (Class I, LOE C).4
In a Cochrane review of the literature, researchers in New Zealand led by Meme Wijesinghe found that, although evidence is limited, it suggests that routine use of high-flow oxygen in uncomplicated MI may result in a greater infarct size and possibly increase the risk of mortality.5 These authors concluded it is well-established that arterial oxygen tension is a major determinant of coronary artery blood flow and that high-flow oxygen therapy can cause a reduction in cardiac output and stroke volume. They concluded there is insufficient evidence to support the routine use of high-flow oxygen in the treatment of uncomplicated MI, and that it may increase mortality.

Stroke Patients

Stroke patients should be managed similarly. Administer supplemental oxygen to stroke patients who are hypoxemic or when oxygen saturations are not obtainable; the goal is to maintain a saturation of 94% or greater.

COPD Patients

The role of oxygen in chronic obstructive pulmonary disease (COPD) patients has been debated for decades. Issues such as a theoretical “hypoxic drive” in patients with COPD and chronic hypercarbia have led to controversies over how much oxygen to give them. While hypoxia must be corrected quickly when it exists, the definition of hypoxia in terms of oxygen saturation has been unclear. For example, a normal person without a respiratory condition breathing room air will usually have a saturation varying from 97%–99%, depending on tidal volume and other normal respiratory variances. It is almost impossible to achieve 100% saturation by breathing room air. We know a saturation of 90% correlates to approximately 60 mmHg pressure, and that is the normal threshold of respiratory distress. However, COPD patients may be accustomed to less saturation, and they typically do well at 88%–92%.
In a study of 405 patients in Australia published in 2010, Dr. Michael Austin and colleagues compared the outcomes of COPD patients who were given standard high-flow oxygen treatment with those given titrated oxygen treatment by paramedics. Titrated oxygen treatment reduced mortality compared with high-flow oxygen by 58% for all patients.6


In a 2012 study of prehospital noninvasive ventilation in patients with pulmonary edema and/or COPD, asthma and pneumonia, a team led by Dr. Bryan Bledsoe found that use of CPAP with a low oxygen percentage (FiO2) of 28%–32% was highly effective in treatment of respiratory emergencies by medics. Since most CPAP setups deliver 100% oxygen, it may be worthwhile for services to explore the value of using setups with a lower oxygen percentage.7

Post-Cardiac Resuscitation Patients

Finally, the role of oxygen after cardiac resuscitation must be mentioned. At one time we attempted to push as much oxygen as possible into cardiac arrest patients on the theory that myocardial oxygen supplies were quickly dwindling, and that if we wanted to save people, we had to replenish the missing oxygen. During arrest, and if we were fortunate enough to get a return of spontaneous circulation, we bagged patients as fast and hard as we could, thinking we were restoring oxygen to ischemic cardiac and brain cells.
Now we know that while ischemia is responsible for most cases of cardiac arrest, managing reperfusion of ischemic cardiac cells is more complicated than we thought. Because of the role of ROS (free radicals), we now understand that a flood of oxygen into previously ischemic cardiac cells is harmful.
The latest post-cardiac arrest care guidelines from AHA recommend the following: Avoid excessive ventilation. Start at 10–12 breaths/min and titrate to target PetCO2 of 35–40 mmHg. When feasible, titrate FiO2 to minimum necessary to achieve SpO2 equal to or greater than 94%.8

Conclusion

In Adriane’s copy of Emergency Care and Transportation, pulse oximetry was not even mentioned because it was not routinely available on ambulances then. Now that we routinely monitor SpO2 for most patients and know what we do about the dangers of hyperoxygenation, it makes sense to give only as much oxygen as the patient requires.
In the early days of EMS, venturi masks were popular and routinely used for COPD and cardiac patients. Following the 1994 revision of the EMT National Standard Curriculum, these were largely abandoned because it was felt high concentrations of oxygen were an acceptable risk, given the curriculum’s time limitations. We may see a return of venturi masks to EMS as we become more aware of the need to limit oxygen percentages in our therapy.
In the past 20 years, the debate in oxygen therapy has largely been confined to high-flow versus low-flow. Given the current research and assessment tools available to us, it would seem the debate should shift to low-flow versus no supplemental oxygen at all. We have the means to titrate oxygen therapy to patients’ needs, and those needs most often can be met by low-flow oxygen.
By no means do we suggest that patients who need oxygen be denied it. Hypoxia must be corrected immediately. But you can have too much of a good thing.

References

1. Stockinger ZT, McSwain NE Jr. Prehospital supplemental oxygen in trauma patients: its efficacy and implications for military medical care. Mil Med, 2004 Aug; 169(8): 609–12.
2. Hughes S. Oxygen for MI: More harm than good? TheHeart.org, www.theheart.org/article/1270299.do.
3. McNulty PH, et al. Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization. Am J Physiol Heart Circ Physiol, 2005; 288: H1057–62.
4. Circulation, 2010; 122: S787–817.
5. Wijesinghe M, Perrin K, Ranchord A, Simmonds M, Weatherall M, Beasley R. Routine use of oxygen in the treatment of myocardial infarction: systematic review. Heart, 2009; 95: 198–202.
6. Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomized controlled trial. BMJ, 2010 Oct 18; 341: c5462.
7. Bledsoe BE, Anderson E, Hodnick R, Johnson L, Johnson S, Devendorf E. Low-fractional oxygen concentration continuous positive airway pressure is effective in the prehospital setting. Prehosp Emerg Care, 2012 Apr–Jun; 16(2): 217–21.
8. Circulation, 2010; 122: S768–86.
William E. “Gene” Gandy, JD, LP, has been a paramedic and EMS educator for more than 30 years. He has implemented a two-year associate degree paramedic program for a community college, served as both a volunteer and paid paramedic, and practiced in both rural and urban settings and in the offshore oil industry. He has testified in court as an expert witness in a number of cases involving EMS providers and lectures on medical/legal aspects of EMS. He lives in Tucson, AZ.


Steven “Kelly” Grayson, NREMT-P, CCEMT-P, is a critical care paramedic for Acadian Ambulance in Louisiana. He has spent the past 14 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the Louisiana Association of Nationally Registered EMTs. He is a frequent EMS conference speaker and author of the book En Route: A Paramedic’s Stories of Life, Death, and Everything In Between, and the popular blog A Day in the Life of an Ambulance Driver.

Information from: EMSWORLD.COM

domingo, 21 de enero de 2024

Can oxygen hurt our patients?

Can oxygen hurt our patients?


Can oxygen hurt our patients?

The drug we use most often in EMS can cause harm if we give it without good reason

Updated October 24, 2016
EMS providers began giving oxygen not because it had medically or scientifically demonstrated benefits for patients, but because they could. Yet, inarguably, hypoxia is bad.
John Scott Haldane, who formulated much of our understanding of gas physiology, said in 1917, “Hypoxia not only stops the motor, it wrecks the engine.”
Patients begin to suffer impaired mental function at oxygen saturations below 64 percent. People typically lose consciousness at saturations less than 56 percent, giving airplane passengers no more than 60 seconds to breathe supplemental oxygen when an airplane flying at 30,000 feet suddenly depressurizes [1-3].
More recent studies suggest that hyperoxia, or too much oxygen, can be equally dangerous. Hence the drug EMS providers administer most often may not be as safe as originally thought.
Studies on benefits and dangers of oxygen therapy are not new; intensive care practitioners have long recognized the adverse effects of using high concentration oxygen [4]


The Amercian Heart Association Guidelines for Emergency Cardiac Care and CPR in 2000 and 2005 recommended against supplemental oxygen for patients with saturations above 90 percent. The 2010 ECC Guidelines called for supplemental oxygen only when saturations are less than 94 percent [5]. Though the AHA continues to recommend high-flow oxygen administration when CPR is in progress.
Research on patient outcomes after hyperoxia
What is new are prehospital research studies comparing outcomes of patients treated without oxygen or with oxygen titrated to saturations versus patients routinely given high flow oxygen. These data are frightening; they invariably show impressive patient harm from even short periods of hyperoxia. 
We’ve known since 1999 that oxygen worsened survival in patients with minor to moderate strokes and made no difference for patients with severe stroke [6]. In fact, the American Heart Association recommended in 1994 against supplemental oxygen for non-hypoxemic stroke patients.
The dangers from giving oxygen to neonates have also been long appreciated [7]. The most compelling outcome studies of neonates published in 2004 and repeated in 2007 showed a significant increase in mortality of depressed newborns resuscitated with oxygen (13 percent) versus room air (8 percent) [9]. This led to the current neonatal resuscitation recommendations for use of room air positive pressure ventilation.
In 2002, a study of 5,549 trauma patients in Texas showed prehospital supplemental oxygen administration nearly doubled mortality [9]. A Tasmanian study of prehospital difficulty breathing patients published in 2010 compared patients treated with oxygen titrated to saturations of 88 to 92 percent to patients treated with non-rebreather oxygen masks.
It showed a reduction in deaths during subsequent hospitalization of 78 percent in COPD patients and 58 percent in all patients [10]. New studies are showing a troubling pattern of worse outcomes associated with hyperoxia post cardiac arrest [11].
Why would oxygen worsen patient outcomes?
One mechanism may be absorption atelectasis. Gas laws mandate that increases in the concentration of one gas will displace or lower the concentration of others. Room air normally contains 21 percent oxygen, 78 percent nitrogen, and less than 1 percent carbon dioxide and other gases.

Nitrogen, the most abundant room air gas, is responsible for secretion of surfactant, the chemical that prevents collapse of the alveoli at end expiration. Premature infants often are not developed sufficiently to produce surfactant and require endotracheal administration of animal surfactant.
“Washout” of nitrogen in adult lungs occurs when high concentration oxygen is administered. Lower concentrations of nitrogen can lead to decreased surfactant production with subsequent atelectasis and collapse of alveoli, significantly impeding oxygen exchange.
Oxygen is also a free radical, meaning that it is a highly reactive species owing to its two unpaired electrons. From a physics perspective, free radicals have potential to do harm in the body.
The sun, chemicals in the atmosphere, radiation, drugs, viruses and bacteria, dietary fats, and stress all produce free radicals. Cells in the body endure thousands of hits from free radicals daily.
Normally, the body fends off free radical attacks using antioxidants. With aging and in cases of trauma, stroke, heart attack or other tissue injury, the balance of free radicals to antioxidants shifts.
Cell damage occurs when free radicals outnumber antioxidants, a condition called oxidative stress. Many disease processes including arthritis, cancer, diabetes, Alzheimer’s and Parkinson’s result from oxidative stress.
The concept of free radical damage suggests the old EMS notion that, “high flow oxygen won’t hurt anyone in the initial period of resuscitation” may be dead wrong.
Tissue damage is directly proportionate to the quantity of free radicals present at the site of injury. Supplemental oxygen administration during the initial moments of a stroke, myocardial infarct (MI) or major trauma may well increase tissue injury by flooding the injury site with free radicals.
Finally, consider this: five minutes of supplemental oxygen by non-rebreather decreases coronary blood flow by 30 percent, increases coronary resistance by 40 percent due to coronary artery constriction, and blunts the effect of vasodilator medications like nitroglycerine [12]. These effects were demonstrated dramatically in cath lab studies [13] published in 2005.
Now you know why the ECC Guidelines recommend against supplemental oxygen for chest pain patients without hypoxia. Supplemental oxygen reduces coronary blood flow and renders the vasodilators ALS providers use to treat chest pain ineffective.
Where do we go from here?
Knowing that both hypoxia and hyperoxia are bad, EMS providers must stop giving oxygen routinely. Oxygen saturations should be measured on every patient.
Protocols need to be aligned to reflect the current ACLS and BLS ECC guidelines: administer oxygen to keep saturations between 94 and 96 percent. No patient needs oxygen saturations above 97 percent and in truth, there is little to no evidence suggesting any clinical benefit of oxygen saturations above 90 percent in any patient.
Modifications in prehospital equipment will be inherent in controlling oxygen doses administered to patients. In all likelihood, the venturi mask will make a comeback, allowing EMS providers to deliver varied concentrations of oxygen as needed to keep oxygen saturations between 94 and 96 percent.
Few patients will require non-rebreather masks which are prone to deliver too much oxygen (hyperoxia). CPAP (Continuous Positive Airway Pressure) devices will also need redesign as most conventional EMS CPAP delivers 100 percent oxygen. A study conducted by Bledsoe, et al in Las Vegas found that prehospital CPAP using low oxygen levels (28 to 30 percent) was highly effective and safe [14].
Bottom line: the drug we use most often can cause harm if we give it without good reason. In the absence of low saturations, oxygen will not help patients with shortness of breath and it may actually hurt them. The same holds true for neonates and virtually any patient with ongoing tissue injury from stroke, MI or trauma. Indeed, oxygen can be bad.
References:
  1. Akero A, Christensen CC, Edvardsen A, et al. Hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight. Eur Respir J 2005;25:725–30.
  2. Cottrell JJ, Lebovitz BL, Fennell RG, et al. Inflight arterial saturation: continuous monitoring by pulse oximetry. Aviat Space Environ Med 1995;66:126–30.
  3. Hoffman CE, Clark RT, Brown EB. Blood oxygen saturations and duration of consciousness in anoxia at high altitudes. Am J Physiol 1946;145:685–92.
  4. Alteiemer WA, Sinclair SE. Hyperoxia in the intensive care unit: why more is not always better. Curr Opin Crit Care 2007;13:73-78.
  5. O'Connor RE, Brady W, Brooks SC, Diercks D, Egan J, Ghaemmaghami C, Menon V, O'Neil BJ, Travers AH and Yannopoulos D. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science Part 10: Acute Coronary Syndromes. Circulation 2010; 122: S787-S817.
  6. Ronning OM, Guldvog B. Should Stroke Victims Routinely Receive Supplemental Oxygen? A Quasi-Randomized Controlled Trial. Stroke 1999;30:2033-2037.
  7. Rabi Y, Rabi D, Yee W: Room air resuscitation of the depressed newborn: a systematic review and meta-analysis. Resuscitation 2007;72:353-363.
  8. Davis PG, Tan A, O’Donnell CP, et al: Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis. Lancet 2004;364:1329-1333.
  9. Stockinger ZT, McSwain NE. Prehospital Supplemental Oxygen in Trauma Patients: Its Efficacy and Implications for Military Medical Care. Mil Med. 2004;169:609-612.
  10. Austin MA, Wills KE, Blizzard L, Walters EH, Wood-Baker R. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ 2010;341:c5462.
  11. Kilgannon JH, Jones AE, Parillo JE, at al. Emergency Medicine Shock Research Network (EMShockNet) Investigators. Relationship between supranormal oxygen tension and outcome after resuscitation from cardiac arrest. Circulation 2011;14:2717-2722.
  12. Harten JM, Anderson KJ, Kinsella J, et al. Normobaric hyperoxia reduces cardiac index in patients after coronary artery bypass surgery. J Cardiothorac Vasc Anesth 2005;19:173–5.
  13. McNulty PH, et al. Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization. Am J Physiol Heart Circ Physiol 2005; 288: H1057-H1062.
  14. Bledsoe BE, Anderson E, Hodnick R, Johnson S, Dievendorf E. Low-Fractional Oxygen Concentration Continuous Positive Airway Pressure Is Effective In The Prehospital Setting. Prehosp Emerg Care 2012;16:217-221.

About the author

Mike McEvoy, PhD, NRP, RN, CCRN is the EMS Coordinator for Saratoga County, New York and a paramedic supervisor with Clifton Park & Halfmoon Ambulance. He is a nurse clinician in cardiothoracic surgical intensive care at Albany Medical Center where he also Chairs the Resuscitation Committee and teaches critical care medicine. He is a lead author of the “Critical Care Transport” textbook and Informed® Emergency & Critical Care guides published by Jones & Bartlett Learning. Mike is a frequent contributor to EMS1.com and a popular speaker at EMS, Fire, and medical conferences worldwide.Contact Mike at mike.mcevoy@ems1.com.

posted by Dr. Ramon ReyesMD 🧩 𓃗 #DrRamonReyesMD 🧩 𓃗 @DrRamonReyesMD

 


Grupo Biblioteca/PDFs gratis en Facebook

Facebook




Pinterest

Twitter

Blog

Gracias a todos el Canal somos mas de  1000 participantes en WhatsApp. Recordar este es un canal y sirve de enlace para entrar a los tres grupos; TACMED, TRAUMA y Científico. ahí es que se puede interactuar y publicar. Si le molestan las notificaciones, solo tiene que silenciarlas y así se beneficia de la informacion y la puede revisar cuando usted así lo disponga sin el molestoso sonido de dichas actualizaciones, Gracias a todos Dr. Ramon Reyes, MD Enlace al 




Enlace a Científico https://chat.whatsapp.com/IK9fNJbihS7AT6O4YMc3Vw en WhatsApp 

tiktok

TELEGRAM Emergencias https://t.me/+sF_-DycbQfI0YzJk  

TELEGRAM TACMED https://t.me/CIAMTO

AVISO IMPORTANTE A NUESTROS USUARIOS
Este Blog va dirigido a profesionales de la salud y público en general EMS Solutions International garantiza, en la medida en que puede hacerlo, que los contenidos recomendados y comentados en el portal, lo son por profesionales de la salud. Del mismo modo, los comentarios y valoraciones que cada elemento de información recibe por el resto de usuarios registrados –profesionales y no profesionales-, garantiza la idoneidad y pertinencia de cada contenido.

Es pues, la propia comunidad de usuarios quien certifica la fiabilidad de cada uno de los elementos de información, a través de una tarea continua de refinamiento y valoración por parte de los usuarios.

Si usted encuentra información que considera errónea, le invitamos a hacer efectivo su registro para poder avisar al resto de usuarios y contribuir a la mejora de dicha información.


El objetivo del proyecto es proporcionar información sanitaria de calidad a los individuos, de forma que dicha educación repercuta positivamente en su estado de salud y el de su entorno. De ningún modo los contenidos recomendados en EMS Solutions International están destinados a reemplazar una consulta reglada con un profesional de la salud.

  1. Tags
  2.  
  3. AHA CPR Guidelines
  4.  
  5. Airway Management
  6.  
  7. EMS Education
  8.  
  9. EMS Training
  10.  
  11. Evergreen
  12.  
  13. Fire-EMS
  14. Gear / Gadgets
  15.  
  16. Medical / Clinical
  17.  
  18. Medical Monitoring
  19.  
  20. Opioids
  21.  
  22. Oxygen
  23.  
  24. Oxygen Administration
  25. Pharmacology
  26.  
  27. Products
  28.  
  29. Pulse Oximetry
  30.  
  31. STEMI
  32.  
  33. Stroke
  34.  
  35. Stroke Care
  36.  
  37. Survivability
  38.  
  39. Traum