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Rapid
Defibrillation by Security Officers after Cardiac Arrest in Casinos
Automated external defibrillators were placed in casinos in Nevada and Mississippi,
and security guards were trained in their use. The devices were used in
105 patients with cardiac arrest due to ventricular fibrillation. A total
of 56 patients (53 percent) survived to hospital discharge. Among the 90
patients whose collapse was witnessed, the survival rate was 74 percent
when the interval between collapse and the first shock was three minutes
or less and 49 percent when the interval was longer.
Automated
External Defibrillators on Aircraft
A U.S. airline equipped its aircraft with automated external defibrillators,
and over two years, the devices were applied to 200 patients by flight attendants
trained in their use. Thirteen of the 14 patients who had ventricular fibrillation
had successful defibrillation with the first shock (defibrillation was withheld
in 1 patient at the family's request), and 40 percent survived to hospital
discharge.
Postoperative
Adjuvant Therapy for Stage II or IIIa NonSmall-Cell Lung Cancer
In a multicenter trial, 242 patients with nonsmall-cell cancer were randomly
assigned to receive postoperative radiotherapy alone and 246 to receive
radiotherapy combined with cisplatin and etoposide. In all patients, the
tumor was completely resected but metastases were present in draining lymph
nodes. The median survival in the two groups was virtually identical: 39
months in the radiotherapy group and 38 months in the combined-treatment
group.
Effects
of Intrathecal Morphine on the Ventilatory Response to Hypoxia
Morphine
administered intrathecally has a potent analgesic action, but it also depresses
respiration. To determine whether this depression is a central or peripheral
effect, the respiratory responses to intrathecal morphine (0.3 mg) and intravenous
morphine (0.14 mg per kilogram of body weight) were studied in 30 normal
men. The ventilatory response to hypercapnia was reduced only by intrathecal
morphine. The ventilatory response to hypoxia was reduced by both intravenous
and intrathecal morphine, but the effect of intrathecal morphine lasted
much longer. |