The Application of the New 2015 Aha Guidelines on Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: On Occasion of a Successful Case at Hanoi Medical University Hospital

Abstract

Cardiac arrest is associated with high mortality if without early diagnosis and cardiopulmonary resuscitation. Each minute without emergency cardiopulmonary resuscitation (CPR), the patient’s chance of survival is reduced by ten percent, even if properly resuscitated but not recirculated, the chance of survival is reduced by four percent. Therefore, CPR should be ferformed as soon as patient is diagnosed with cardiac arrest with the signs of unconsciousness, apnea, loss of carotid pulse and inguinal pulse. Chest compression plays an important role in the success of CPR. There is emphasis on the characteristics of high-quality CPR: compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation. Emergency coronary angiography is recommended for all patients with ST elevation and for hemodynamically or electrically unstable patients without ST elevation for whom a cardiovascular lesion is suspected. All adult patients with return of spontaneous circulation after cardiac arrest should have targeted temperature management (TTM) to prevent poor neurologic outcome. Key words: Cardiac arrest, targeted temperature management, the 2015 AHA Guideline on CPR and ECC

Assessment of Antibiotic Prophylaxis in Surgical Patients and Association Factors at Thu Duc District Hospital, Ho Chi Minh City, Vietnam in 2018

“…Medical records of the group of patients with surgery duration of 120 minutes or less with prophylactic antibiotics treatment in compliance with the rules were 2.784 times higher than those with surgery duration above 120 minutes. Research by Huong showed that there was no relationship between the surgery duration and the use of prophylactic antibiotics, P > .05; it could be explained by the fact that there is various type of diseases in our research while Huong 7 only studied on 1 disease (laparoscopic cholecystectomy) so this difference is explainable. Hospital stays with prophylactic antibiotics treatment complying with the regimen: patients with stays of less than 5 days with prophylactic antibiotics treatment in compliance with the rules accounted for 55.2%, lower than those with 5 or more days of hospital stays (57.7%).…”

“…Table 2 shows that, the proportion of medical records of patients who have used antibiotics before hospitalization is 5.4% (39/724). Huong 7 stated that 21.6% of patients used antibiotics before being hospitalized for endoscopic cholecystectomy at Hanoi Medical University hospital. In case of the use of antibiotics before surgery, the surgeons often consider before deciding whether or not to use prophylactic antibiotics.…”

“…Some common reasons are the difficulty that health workers have not been updated with knowledge, improper habits on the use of preventive antibiotics, and lack of policies. 5-7,12…”