27 November 2009


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Technology has the power to amaze. There are always things being invented and improved on that I would never have thought were needed, or needed to improved upon. I suppose this is the inevitable course of progress, and the result of good marketing. Convincing someone they need something they never even thought or would have imagined even using before. All in the name of profit progress. Herewith an example of such an invention.

I was called to the ER to help with the resuscitation of an elderly man who had been a victim of "collapse". I was needed to manage the airway as (in this country) this is the realm of, and only of, the anaesthetist.
I was amazed upon entering the resus room in the ER, to see an alien spider-like contraption straddling the patient, and very efficiently thumping his chest. I had never imagined, never mind seen anything like it before. I felt as if I was Dr Spock entering a set on Star Trek. It even made futuristic pneumatic type noises.

I tubed him and hooked him up to the ventilator. He was then on what I could call fully automated, synchronised CPR. The only medical person making contact was the ER guy checking pulses every 2 minutes and injecting the required drugs (according to the ACLS protocol), while the rest of us stood around and watched in amazement.

After some time, the clerk arrived with the patients old hospital chart, and joined the line to watch the events unfold. It turned out that the patient had prevoiusly signed a DNR due to his age and heart condition, but no-one there had known this. After 65 minutes in total, it was decided that everyone had seen enough of this new machine, and the chief ER guy decided it was time to stop.

To our surprise, when it was stopped, his pulse returned, and stayed there! Irregular, but palpable. I admitted him to the ICU, expecting him to slip slowly into eternity during the night. He didn't. I extubated him the next morning, and was fascinated to find no obvious neurological deficit (this is almost a certainty even after 30 minutes of ordinary CPR, with the exception of cases of hypothermia or drowning). This was a most unexpected, but welcome outcome.

I couldn't help think that this machine would have been of great help back home in one of those one man resus situations that tend to occur every now and then (when the nurses all take tea at the same time).
I think every theatre, ward, ER and ambulance should have one, and store it next to their defibrillator.

It's only disadvantage is that it would encourage the perpetuation of obesity among nurses by removing the only bit of compulsory exercise a lot of them get.

I should state that I have no conflict of interest. I was just utterly amazed by the efficiency of this apparatus.

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