Evaluation of lay skills in cardiopulmonary resuscitation.

The theoretical knowledge and practical performance of 166 lay people attending a short cardiopulmonary resuscitation course were evaluated according to the American Heart Association standards. Before tt course no participant was able to perform even a bad attempt at cardiopulmonary resuscitation. Theoretical knowledge was good at the end of the course and at the refresher course six months later. At the end of the initial course 65% (57/88) of the participants examined could adequately compress and ventilate the manikin. After six months 44% (30/68) could perform resuscitation adequately. Women were as proficient as men, and elderly people in general were as proficient as the younger ones. The skill of carotid artery palpation was surprisingly well retained after six months. Data on pulmonary ventilation and cardiac massage were recorded simultaneously on a recording resuscitation manikin. When these objective data were compared with the American Heart Association standards only a few participants were able to perform correct cardiopulmonary resuscitation. The number of compressions and ventilations per minute were often insufficient. A large discrepancy between self, subjective, and objective assessment of cardiopulmonary resuscitation knowledge and performance was found. The importance of a rapid diagnosis, an immediate call for help, an adequate rate of cardiac massage, and a reduction in the time needed for ventilation should be emphasised at these courses. Refresher courses should be provided at least twice a year.

Maternal morbidity due to beta-adrenergic therapy. Pre-existing cardiomyopathy aggravated by fenoterol.

In the 32nd wk, fenoterol was administered to a patient during her first pregnancy because of premature rupture of the membranes and uterine contractions after 2 wk of medication. At 8 microgram/min of fenoterol, total irregularity of the maternal pulse occurred. In the 35th wk, cesarean section had to be performed because of fetal asphyxia at 5 cm of cervical dilatation. Intensive care treatment of the mother was necessary during the postoperative phase. The diagnosis of pre-existing congestive cardiomyopathy was made. Non-invasive examination of the heart is advised before beta-adrenergic drugs are given.

A study of systolic time intervals during uninterrupted exercise.

A method has been developed for obtaining measurements of the systolic time intervals during uninterrupted graded exercise in the upright position on a bicycle ergometer. The method has been applied to 112 subjects divided into 4 groups: two of normal subjects below and above the age of 40, respectively (mean ages 30 and 48 years), and two of patients (mean ages for each about 50 years), both with coronary insufficiency, but one without and the other with abnormality of left ventricular function as shown by ventriculography. The measurements obtained yield linear relations between total electromechanical systole (QS2) and heart rate, between pre-ejection period (PEP) and RR interval for each subject. The average standard deviation about the regression is less than 6 ms for all three regression lines; the average correlation coefficient is greater than 0-93. The younger group of normal subjects have a significantly shorter PEP compared to the older group. Indices have been derived which separate the patient groups from each other and from the normal subjects. Using these indices 86 per cent of all the subjects were correctly classified according to the group to which they belonged. It is concluded that measurements of STI during uninterrupted exercise offer valuable information in the assessment of cardiac patients.