Ex-vivo and live animal models are equally effective training for the management of a penetrating cardiac injury.

Background: Live tissue models are considered the most useful simulation for training in the management for hemostasis of penetrating injuries. However, these models are expensive, with limited opportunities for repetitive training. Ex-vivo models using tissue and a fluid pump are less expensive, allow repetitive training and respect ethical principles in animal research.

Immature platelet fraction predicts coagulopathy-related platelet consumption and mortality in patients with sepsis.

Introduction: The diagnostic and prognostic value of immature platelet fraction (IPF) in sepsis has not been determined. This study aimed to assess whether IPF is an early predictor of platelet decline due to coagulopathy and is associated with mortality in patients with sepsis.

Materials And Methods: In total, 149 patients with a platelet count of ≥80×10(3)/μL on intensive care unit admission (101 with sepsis, 48 controls without sepsis) were prospectively evaluated.

Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders.

Introduction: Shortening response time to an emergency call leads to the success of resuscitation by chest compression and defibrillation. However, response by ambulance or fire truck is not fast enough for resuscitation in Japan. In rural areas, response times can be more than 10 minutes.

Predicting the need for massive transfusion in trauma patients: the Traumatic Bleeding Severity Score.

Background: The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system.

Development of a first-responder dispatch system using a smartphone.

We constructed a prototype community first responder (CFR) dispatch system. The system sends incident information, including a map, to the chosen CFR's mobile phone. We tested it in a simulation of 30 out-of-hospital cardiac arrest incidents which had occurred in the town of Motegi during the previous year.

Introduction of the community first responder system into Japan: is that possible?

Background: To improve out-of-hospital cardiac arrest (OHCA) survival rates in Japan, implementation of a community first responder (CFR) system is considered one of the most effective emergency medical service options. We investigated the possibility of introducing a CFR system in Japan.

Methods: Cross-sectional surveys were given to 1,350 residents over the age of 18 who were selected from resident registration lists in Tochigi prefecture.

Ex-vivo porcine organs with a circulation pump are effective for teaching hemostatic skills.

Surgical residents have insufficient opportunites to learn basic hemostatic skills from clinical experience alone. We designed an ex-vivo training system using porcine organs and a circulation pump to teach hemostatic skills. Residents were surveyed before and after the training and showed significant improvement in their self-confidence (1.

Successful management of aortic thrombi resulting in spinal cord infarction in a patient with antiphospholipid antibody syndrome and acute cholecystitis.

A 74-year-old man with coronary artery disease was suffering from acute nonobstructive cholecystitis and was admitted to a nearby hospital. Dual antiplatelet (aspirin and ticlopidine) therapy was discontinued before preparation for surgical resection of the gall bladder. During his time in hospital he was aware of lumbar pain and weakness in both legs.

Evaluation of the user interface simplicity in the modern generation of mechanical ventilators.

Objective: We designed this study to evaluate the simplicity of the user interface in modern-generation mechanical ventilators. We hypothesized that different designs in the user interface could result in different rates of operational failures.

Setting: A laboratory in a tertiary teaching hospital.

Sonographic diagnosis and successful nonoperative management of sealed perforated duodenal ulcer.

We encountered a case of sealed perforated duodenal ulcer in a 75-year-old woman with rheumatoid arthritis and chronic renal failure. Abdominal sonography showed a bright linear echo within the thickened anterior wall of the duodenal bulb and the presence of free air at the anterior surface of the liver. We found no signs of direct communication between the duodenal lumen and the peritoneal cavity or any free fluid.