998 resultados para Todd, John, 1800-1873.


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OBJECTIVE: In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. METHODS: This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. RESULTS: During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. CONCLUSIONS: This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery rate and false positive are similar to those found in previous studies. We found our results satisfying the given short time frame of this study. Our results demonstrate that it is possible to improve the quality of emergency services at moderate or even no additional costs and this should be of interest to all EMS that do not presently benefit from using T-CPR procedures. EMS that currently do not offer T-CPR should consider implementing this technique as soon as possible, and we expect our experience may provide answers to those planning to incorporate T-CPR in their daily practice.

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Presenta los resultados del comportamiento de las redes de arrastre pelágicas tipo japonés 124/1800 y 216/800 utilizada en la toma de muestras en la estimación del stock de recursos pelágicos: anchoveta, sardina, jurel, caballa y samasa durante el crucero hidroacústico 9805-06 a bordo del BIC José Olaya Balandra.

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Los resultados del Crucero 9902-03 de Evaluación Hidroacústica de los Recursos Pelágicos: anchoveta (Engraulis ringens), sardina (Sardinops sagax sagax), jurel (Trachurus picturatus murphyi), caballa (Scomber japonicus) y samasa (Anchoa nasus), a bordo del BIC José Olaya Balandra, entre Zorritos (Tumbes) y Los Palos (Tacna), del 10 de febrero al 1 de abril 1999, muestran que la red de arrastre pelágica 124/1800 tuvo una buena eficiencia y comportamiento en 168 lances de comprobación. Se obtuvo una captura total de 57.032,55 kg; correspondieron a la anchoveta 36.902,6 kg; sardina 302,6 kg; jurel 43,9 kg; caballa 1.256,3 kg; samasa 3.160,8 kg y otros recursos 15.366,35 kg. El índice de captura total (CPUE) fue de 1.035,07 kg/h ejerciendo mayor esfuerzo en la anchoveta con 669,74 kg/h. Se determinó que el mayor porcentaje de mezcla de los 153 lances con recursos pelágicos correspondió a la anchoveta con otros recursos a 5 mn de distancia de la costa. Se determinó el área de la boca de la red y el volumen de agua filtrada en una milla náutica de arrastre. Los datos de comportamiento de la red: abertura horizontal de la boca, abertura vertical, profundidad de la red y distancia entre la relinga inferior al fondo, etc., se obtuvieron en forma directa por medio de una net sonda RX 400 SCANMAR interconectada a un sistema de post-procesamiento.

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Se presentaron los resultados de la modificación y adaptaciones de la red pelágica 124/1800 para la captura del recurso Vinciguerria.

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Durante este estudio se registraron valores de ecointegración y CPUE altos durante la noche, cuando los peces estaban más concentrados cerca de la superficie en una capa de 50 metros de profundidad.