[Cardiac arrest under special circumstances]. / Kreislaufstillstand unter besonderen Umständen: Leitlinien des European Resuscitation Council 2021.

These guidelines of the European Resuscitation Council (ERC) Cardiac Arrest under Special Circumstances are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required for basic and advanced life support for the prevention and treatment of cardiac arrest under special circumstances; in particular, specific causes (hypoxia, trauma, anaphylaxis, sepsis, hypo-/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), specific settings (operating room, cardiac surgery, cardiac catheterization laboratory, dialysis unit, dental clinics, transportation [in-flight, cruise ships], sport, drowning, mass casualty incidents), and specific patient groups (asthma and chronic obstructive pulmonary disease, neurological disease, morbid obesity, pregnancy).

European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances.

These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy).

The comprehensive medical preparedness in chemical emergencies: 'the chain of chemical survival'.

Medical management of victims of chemical incidents includes supportive therapy, decontamination and antidote administration. Chemical weapons of mass destruction are available to many countries and are a possible alternative to conventional weapons for terrorist groups. During the last 5 years, some Italian institutions have made big efforts to establish a national system of antidote stockpiling and distribution. Little or no efforts have been addressed to other aspects of the medical management of patients exposed to chemical agents, such as decontamination, personal protective equipment, and specific supportive therapy. Although antidotes are indispensable instruments for some poisonings, as nerve agent and botulin intoxication, antidote stockpiling cannot be considered the only objective of a comprehensive medical preparedness for chemical emergencies. This paper addresses the medical priority when approaching victims of chemical emergencies. The priority actually is to establish a chain of chemical survival in which antidote administration is one out of several links.

[A relational database to store Poison Centers calls]. / Un database relazionale per l'archiviazione delle chiamate ad un Centro antiveleni (CAV).

Italian Poison Centers answer to approximately 100,000 calls per year. Potentially, this activity is a huge source of data for toxicovigilance and for syndromic surveillance. During the last decade, surveillance systems for early detection of outbreaks have drawn the attention of public health institutions due to the threat of terrorism and high-profile disease outbreaks. Poisoning surveillance needs the ongoing, systematic collection, analysis, interpretation, and dissemination of harmonised data about poisonings from all Poison Centers for use in public health action to reduce morbidity and mortality and to improve health. The entity-relationship model for a Poison Center relational database is extremely complex and not studied in detail. For this reason, not harmonised data collection happens among Italian Poison Centers. Entities are recognizable concepts, either concrete or abstract, such as patients and poisons, or events which have relevance to the database, such as calls. Connectivity and cardinality of relationships are complex as well. A one-to-many relationship exist between calls and patients: for one instance of entity calls, there are zero, one, or many instances of entity patients. At the same time, a one-to-many relationship exist between patients and poisons: for one instance of entity patients, there are zero, one, or many instances of entity poisons. This paper shows a relational model for a poison center database which allows the harmonised data collection of poison centers calls.

[In-hospital management of victims of chemical weapons of mass destruction]. / La gestione intraospedaliera dei pazienti esposti ad armi chimiche di distruzione di massa.

Emergency situations caused by chemical weapons of mass destruction add a new dimension of risk to those handling and treating casualties. The fundamental difference between a hazardous materials incident and conventional emergencies is the potential for risk from contamination to health care professionals, patients, equipment and facilities of the Emergency Department. Accurate and specific guidance is needed to describe the procedures to be followed by emergency medical personnel to safely care for a patient, as well as to protect equipment and people. This review is designed to familiarize readers with the concepts, terminology and key operational considerations that affect the in-hospital management of incidents by chemical weapons.