ABSTRACT
Objective: To survey the times to critical actions (defibrillator and doctor presence, initiation of chest compression) of in-hospital simulated cardiopulmonary resuscitation (CPR). Methods: A 1-year retrospective simulated audit 2009 in a 2,400-bed university hospital in Thailand. Results: A total of 57 adult wards (around a third of all wards in the hospital), including intensive care units, critical wards, procedural units, general wards and out-patient units were audited. Overall, the median time of initiation of chest compression and defibrillator presence among CPR teams were 1.27 (0.35-7.19) and 1.16 (0.00-26.00) minutes, respectively. The median time of the first doctor presence was 3.45 (0.00-15.15) minutes. However, there were significant differences in time to defibrillator and doctor presence among wards. The longer time of these critical managements were recorded in non-monitored areas (general wards and out-patient units) (p = 0.004 and 0.007, respectively). Conclusion: In our CPR simulated survey, delayed initiation of critical managements commonly occurred in non-monitored areas. Better management should be concerned for favorable outcomes.
ABSTRACT
The human respiratory system begins to form about day 26-27 after fertilization. It is first indicated by a median laryngotracheal groove in the caudal and ventral wall of pharynx. The endoderm which lines the laryngotracheal groove gives rise of the epithelium and glands of the larynx, trachea, bronchi and the pulmonary lining epithelium. The connective tissue, the cartilage and the smooth muscle of these structures develop from the splanchnic mesoderm surrounding the forgut. In studying the development of the respiratory system at the Department of Anatomy, Siriraj Hospital medical students should trace the serial section of 10 mm. pig embryos. In doing this, they will be able to observe the laryngotracheal groove at the floor of the pharynx and when tracing the sections caudally, they will be able to observe the trachea, esophagus and the bifurcation of the trachea forming primary bronchi as well as smaller of branches of present study attempts to show the development of respiratory system of rabbit embryos in order to find the most suitable for use for as a laboratory model for medical students, embryological studies. A 10mm. rabbit embryo can be used instead of a pig embryo for studying the development of the respiratory system, as nowadays pig embryos are not available.
ABSTRACT
The urogenital system develops from the intermediate mesoderm, the coelomic epithelium and the endoderm of the urogenital sinus. The urinary system of mammal is characterized by three sets of kindneys, i.e. the nonfunctional pronephros, the mesonephros and the functional metanephros. The metanephros or the permanent kidney develops from the ureteric bud and metanephrogenic tissue. At the beginning the kidney is located in the pelvic region but later gradually ascends to the abdomen. The urinary bladder development of human urinary system in the Department of Anatomy, Siriraj Hospital, we have employed serial sections of 10-15 mm pig embryos as laboratory models. This method of laboratory study is helpful in understanding and recognizing how the kidney forms. It is quite regrettable that nowadays the pig embryos are no longer available. Thus, it is necessary to find another suitable laboratory model and study the details of its normal kidney development. In this study, we demonstrated that 12-14 mm rabbit embryos can be used instead of pig embryos as the development of the metanephros is very similar. Although the rabbit’s mesonephros is smaller than that of the pig, it resembles the human mesonephros more closely. For this reason, the rabbit embryo is suitable for use as a laboratory model for embryology education of urinary system.
ABSTRACT
Serial sections of 4-14 mm rabbit embryos were carefully studied in relation to the serial section of 10 mm pig embryos under a light microscope in order to compare the development of the heart and related blood vessels. The heart of the 4-14 mm rabbit embryo has incompletely divided chambers comprising two atria and two ventricles. The partition of the atrium by the septum primum can be seen at the 4 mm stage and still incompletely attaches to the endocardial cushion even at the 12 mm stage. The rupture of the septum primum brings about the communication between the two atria, the foramen secundum, can be seen only at the 12 mm stage. Communication between the two ventricles is also via the interventricular foramen. The right atrium receives venous blood from the right horn of the sinus venosus which is larger than the left side. The bulbus cordis communication with the right ventricle and brings blood to the aortic sac which extends branches to the branchial arches to join the right ventricle and brings blood to the aortic sac which extends branches to the branchial arches to join the dorsal aorta. The heat of the rabbit embryo is very similar to that of the pigembryo. The pig embryos are easy to obtain for slide preparation, there will be no problem in using rabbit embryos for the study of the development of the heart.