Comparing Surf Lifeguards and Nurse Anesthetists' Use of the i-gel Supraglottic Airway Device - An Observational Simulation Study.

PURPOSE: Using a supraglottic airway (SGA) may provide more effective ventilations compared with a mouth-to-pocket-mask for drowning victims. SGAs are widely used by nurse anesthetists but it is unknown whether surf lifeguards can use SGAs effectively. We aimed to compare the use of SGA by surf lifeguards and experienced nurse anesthetists. MATERIALS AND METHODS: Surf lifeguards inserted a SGA (i-gel O2, size 4) in a resuscitation manikin during cardiopulmonary resuscitation (CPR) and nurse anesthetists inserted a SGA in a resuscitation manikin placed on a bed, and performed ventilations. Outcome measures: time to first ventilation, tidal volume, proportion of ventilations with visible manikin chest rise, and ventilations within the recommended tidal volume (0.5-0.6 L). RESULTS: Overall, 30 surf lifeguards and 30 nurse anesthetists participated. Median (Q1-Q3) time to first ventilation was 20 s (15-22) for surf lifeguards and 17 s (15-21) for nurse anesthetists (p=0.31). Mean (SD) tidal volume was 0.55 L (0.21) for surf lifeguards and 0.31 L (0.10) for nurse anesthetists (p<0.0001). Surf lifeguards and nurse anesthetists delivered 100% and 95% ventilations with visible manikin chest rise (p=0.004) and 19% and 5% ventilations within the recommended tidal volume, respectively (p<0.0001). CONCLUSION: In a simulated setting, there was no significant difference between surf lifeguards and experienced nurse anesthetists in time to first ventilation when using a SGA. Surf lifeguards delivered a higher tidal volume, and a higher proportion of ventilations within guideline recommendations, but generally ventilations caused visible manikin chest rise for both groups.

[Application of arbitrarily primed polymerase chain reaction analysis to epidemiological study of Salmonella enterica serovar enteritidis].

An arbitrarily primed polymerase chain reaction (AP-PCR) DNA profile was applied to epidemiological analysis of Salmonella enterica subsp. enterica serovar Enteritidis. A total 21 strains of S. Enteritidis isolated from 21 cases (10 cases of healthy persons, 7 cases of food poisoning outbreaks and 4 sporadic diarrhea cases), during the period between December 1991 and August 1996 in Wakayama City, were used. A total of 60 arbitrary primers (DNA oligomer (12) set, Wako) were screened with 4 S. Enteritidis strains of different cases. A-11, B-32, C-42 and C-45 primers were chosen. Plasmid DNA profiles, antimicrobial susceptibility patterns and phage types were also examined. The combination of these three methods resolved the collection into five groups (A to E). And type C strains were found in 17 cases (81%) out of 21 cases. However, according to AP-PCR DNA profile, all 21 strains were classified into six groups (I to VI), and 17 type C strains were classified into three groups (III, IV and V). Type IV was predominant in Wakayama City, and type C.IV was found in 15 cases (71%). In conclusion, we considered that AP-PCR DNA profile using appropriate primers was an effective epidemiological marker.

Distinction between Clostridium botulinum type A strains associated with food-borne botulism and those with infant botulism in Japan in intraintestinal toxin production in infant mice and some other properties.

Two strains of Clostridium botulinum type A associated with food-borne botulism and six strains associated with infant botulism in Japan were compared in intraintestinal toxin production in infant mice, in vitro toxin and hemagglutinin production, molecular sizes of the toxins, and some other properties. The infant botulism-associated strains, producing M toxin (Mr 300 kDa) but no hemagglutinin, showed significantly lower 50% infective doses in infant mouse intestines. The antigenicities of the toxin differed between the two groups, while the biochemical properties of the cultures did not. Besides infant botulism-associated strains, this set of properties were found only in a strain isolated from honey of South American origin.

Comparative studies on Clostridium botulinum type A strains associated with infant botulism in Japan and in California, USA.

Twenty strains of Clostridium botulinum type A associated with infant botulism cases, six in Japan and 14 in California, USA, were compared in their characters. All six Japanese strains produced medium-sized progenitor toxin (M toxin; Mr 300 k) but no hemagglutinin and showed lower 50% infective doses (ID50) in the infant mouse test; whereas most American strains produced large-sized progenitor toxin (L + LL toxins; Mr 500 k and 900 k) and hemagglutinin in addition to M toxin and showed higher ID50 in infant mice. No marked difference in the biochemical properties was found between the two groups except for two American strains.

Distinct characters of Clostridium botulinum type A strains and their toxin associated with infant botulism in Japan.

Four strains of Clostridium botulinum type A having been associated with infant botulism in Japan, and another strain isolated from honey not associated with infant botulism, were found to be hemagglutinin (HA) negative. These strains do not produce L (Mr 500 kDa) nor LL toxin (Mr 900 kDa) but M toxin (Mr 300 kDa) only. No marked difference was found between the HA-positive and HA-negative strains in other biochemical properties, but the HA-negative strains tended to colonize more easily in the intestines of infant mice than did HA-positive strains. The toxin of HA-positive strains and that of HA-negative strains differed in the antigenicity of part of the toxic component and that of the nontoxic component, and in the molecular size of the toxic component.