Publications by authors named "Henrik Fischer"
Article Synopsis
- The study compared CPR quality using an automated external defibrillator (AED) with audio instructions only vs. audio plus video instructions among first-year medical students.
- The effectiveness of compressions, including key factors like depth and hand position, did not vary significantly between the two groups, although the video group had more incorrect decompressions.
- While students found the video instructions more supportive, they did not enhance overall CPR performance, suggesting potential cognitive overload, prompting further investigation into video content and its effects on different populations.
Article Synopsis
- The study compared dislocation rates of oral and nasal airway exchange catheters (AEC) in the PACU and found no significant difference, with rates of 7.2% for oral and 2.7% for nasal catheters.
- Retching occurred more frequently with oral catheters (26%) compared to nasal ones (8%), suggesting nasal catheters may be better tolerated.
- Waveform capnography was not effective in predicting dislocation, indicating the need for improved monitoring techniques.
Article Synopsis
- The study examined the effectiveness of verbal feedback from a second rescuer ("human feedback") versus mechanical feedback from a device during CPR training among medical students.
- The "human feedback" group performed as well as the "mechanical feedback" group in terms of CPR quality but was quicker to start compressions and made fewer errors in decompression.
- However, the "human feedback" group experienced more absolute hands-off time, suggesting a need for further investigation into optimizing human feedback training for CPR.
Article Synopsis
- The study evaluated the effectiveness of six airway devices in preventing aspiration during CPR using 30 adult human cadavers.
- Results showed that endotracheal intubation (ETI) significantly reduced the risk of aspiration compared to bag-valve ventilation and some supraglottic airway devices.
- The findings suggest that ETI is the most reliable option for protecting against regurgitation during CPR.
Article Synopsis
- Fluid resuscitation is crucial in treating hemorrhagic shock, and lower volumes of crystalloid fluids may lead to better coagulation profiles compared to higher volumes.
- A study on pigs compared lower volume (one-fold) and higher volume (three-fold) crystalloid resuscitation, finding that lower volume led to less blood dilution and a better coagulation profile despite lower mean arterial pressure.
- While higher volume resuscitation improved mean arterial pressure, it negatively affected core temperature and coagulation markers, suggesting potential complications despite avoiding hyperchloremic acidosis.
Article Synopsis
- The study tested a new double-lumen endotracheal tube (DLT) called VivaSight, which has a built-in camera for better visibility during intubation, against a conventional DLT in thoracic surgery patients.
- The results showed that the VivaSight DLT allowed for faster intubation times (63 seconds on average) compared to the conventional DLT (97 seconds), and it was successfully inserted in all attempts.
- Although it had a slightly higher incidence of airway injuries, the VivaSight DLT proved to be easier to position and adjust, confirming its potential advantages in surgical settings.
Translation of ERC resuscitation guidelines into clinical practice by emergency physicians.
Scand J Trauma Resusc Emerg Med
January 2014
Article Synopsis
- The study compares emergency skills and knowledge of active and inactive out-of-hospital emergency physicians (OOHEP) in Austria attending mandatory refresher courses.
- Active OOHEP are more likely to use specific emergency procedures, such as initiating intraosseous access and therapeutic hypothermia, compared to their inactive counterparts.
- Younger OOHEP and those with recent resuscitation experience show better adherence to the European Resuscitation Council guidelines, indicating practical experience enhances knowledge application.
Article Synopsis
- This study evaluated the effectiveness of a new oral opioid preparation compared to traditional IV morphine for managing postoperative pain after cardiac surgery.
- 51 patients were enrolled, with half receiving oral Targin and the other half using patient-controlled IV morphine; pain scores and side effects were monitored over time.
- Results showed that the total opioid dose was significantly lower with oral opioids while pain scores were similar, indicating oral opioids can effectively manage pain after sternotomy.
Article Synopsis
- Study evaluates the effectiveness of three CPR feedback devices (PocketCPR, CPRmeter, iPhone app PocketCPR) against standard BLS without feedback in a simulated scenario.
- Participants included 240 trained medical students who performed CPR on a manikin for 8 minutes, measuring various CPR quality metrics.
- Results showed that while some feedback devices prevented performance decline, effective compression rates remained low compared to standard BLS, and all devices delayed the start of CPR, potentially impacting outcomes negatively.
Article Synopsis
- The study assessed invasive Candida infections (ICI) in ICU patients post-cardiac surgery, revealing a high mortality rate; 10 out of 169 patients had proven ICI.
- The SOFA score was the only significant risk factor for ICI, while other scores like SAPS II and EuroSCORE were not linked to ICI incidence.
- Empiric antifungal therapy appeared beneficial, as patients receiving it had a lower mortality rate (36.6%) compared to those with proven ICI (80%).
Article Synopsis
- Airway management is crucial in CPR, and recent guidelines emphasize minimizing interruptions, ideally to under 10 seconds; however, EMTs may not have sufficient training for endotracheal intubation, making supraglottic devices a viable alternative.
- A study trained 40 EMTs on six airway devices and evaluated their performance immediately, and again after 1 and 3 months, showing that supraglottic devices had significantly lower hands-off times than endotracheal intubation.
- Results indicated that EMTs could maintain hands-off times within the 10-second limit with supraglottic devices, even after extended periods without practice, suggesting these devices are recommended for EMTs lacking experience in advanced airway management.
Article Synopsis
- The study aimed to compare rescuer exertion when using a manual resuscitation device (Animax) against standard CPR methods.
- Key metrics included heart rate pressure product (RPP), perceived exertion on the Borg scale, fine motor skills, and lactate concentration during performance.
- Results showed no significant difference in RPP, but the MRD led to higher perceived exertion and lactate levels, indicating that while the RPP remained similar, subjective effort was greater with the MRD, suggesting the need for frequent rescuer changes during CPR.
Article Synopsis
- The study introduces an Effective Compression Ratio (ECR) to evaluate the quality of cardiopulmonary resuscitation (CPR) by combining key parameters like compression depth, hand position, and decompression.
- Research involved analyzing CPR studies via PubMed, showing ECR values ranging from 0.03 to 0.67, indicating varied CPR quality.
- The ECR provides a quick and meaningful assessment for CPR performance, making it easier to compare results across studies and adaptable to different training devices and guidelines.
Article Synopsis
- The study explored the effectiveness of various airway management techniques—specifically endotracheal intubation (ETI), mouth-to-mouth ventilation, and supraglottic airway devices (SAD)—performed by medical laypersons trained for just one hour.
- The results showed that while ETI had a success rate of 74% initially, it declined to 64% after three months, whereas all SAD achieved a consistent 100% success rate.
- Ultimately, the findings suggest that SAD are a more efficient and reliable method for securing airways in emergency situations compared to ETI and could be recommended as a primary option for non-professionals.
Article Synopsis
- The study investigates the timing of histological diagnosis of glomerulonephritis (GN) in chronic kidney disease (CKD) and its impact on patient outcomes.
- Early diagnosis at stages 1 and 2 of CKD is linked to better clinical outcomes, including fewer occurrences of death, dialysis, or disease progression.
- The findings suggest that timely histological diagnosis allows for early treatment, improving the chances of preserving kidney function.
Article Synopsis
- The study investigates the use of ROTEM® tests to predict the need for massive transfusion (MT) in trauma patients upon their admission to the emergency room.
- Out of 323 patients analyzed, those who required MT had significantly higher injury severity scores and demonstrated prolonged clotting times and lower maximum clot firmness compared to non-MT patients.
- The study identifies hemoglobin levels and specific ROTEM® parameters (FIBTEM MCF and FIBTEM A10) as strong predictors for MT, indicating their potential utility in early trauma management.
Article Synopsis
- Out-of-hospital emergency physicians in Austria are required to undergo mandatory training and refresher courses for advanced life support (ALS) skills, with this study focusing on their knowledge retention based on participation in ERC-ALS courses.
- The study involved 807 participants who answered multiple-choice questions about ALS, analyzing results in relation to their previous training and various control factors.
- Results indicated that those who attended ERC-ALS courses had better ALS knowledge retention, with age, regularity of emergency work, and recent hands-on resuscitations also influencing performance.
Article Synopsis
- The study investigated the impact of an automated external defibrillator (AED) with audiovisual feedback on CPR quality during basic life support performed by trained laypersons.
- The feedback group demonstrated better compliance with compression rates and effective compressions but maintained a shallower compression depth compared to the control group.
- While the audiovisual feedback improved certain CPR parameters, the reduced compression depth may adversely affect cardiac output, posing a concern for effective resuscitation.
Article Synopsis
- The study aimed to compare the performance of a manually operated mechanical resuscitation device (MRD), called "Animax," with standard single rescuer basic life support (BLS) among 80 trained medical students.
- The use of the MRD resulted in significantly more effective chest compressions, less hands-off time, and a higher minute-volume of ventilation compared to standard BLS; however, both methods failed to meet the 2005 ERC guidelines for ventilation volumes.
- The findings suggest that the MRD is superior for chest compressions in a simulated environment, but further clinical studies are necessary to assess its safety and effectiveness in real patient situations.
Article Synopsis
- The study assessed the effectiveness of mechanical-resuscitation devices (MRD) vs. standard basic life support (BLS) during CPR in a simulated flight environment.
- The results showed that using the MRD significantly reduced the time without hands on the chest during resuscitation, although the overall ventilation quality was worse compared to BLS.
- Despite a higher chest compression rate in the BLS group, further research is needed to see how these differences affect real-life patient outcomes.
Article Synopsis
- The study explored the effectiveness of supraglottic airway devices (SADs) and bag-valve mask (BVM) ventilation in laypeople who received training for airway management.
- i-gel™ and LMA-Supreme™ outperformed both BVM and other SADs in terms of successful application on the first attempt and perceived ease of use during the training sessions.
- Despite some progress, all devices struggled to achieve adequate tidal volumes, indicating a need for improvement in training and techniques used for ventilation.
Article Synopsis
- Thromboembolic and bleeding complications are common in outpatients with left ventricular assist devices, necessitating careful monitoring of both anticoagulant and procoagulant factors, particularly platelet function, which is often overlooked.
- In a study comparing 12 patients with left ventricular assist devices to 12 healthy volunteers, various point-of-care devices were used to assess platelet function, revealing significant impairments in the patients, especially under high shear conditions.
- Results showed that patients had markedly prolonged closure times and abnormal aggregation patterns, suggesting that their platelet dysfunction is more complex than just low von Willebrand factor levels.