Severe pulmonary barotrauma

Pulmonary barotrauma is a well-known but rarely seen complication of mechanical intermittent positive pressure ventilation. It is thought to be related to raised pressures within alveoli which lead to their eventual rupture and the subsequent development of respiratory embarrassment. Mishaps related to faulty one-way valves in the self-inflating, bag-ventilation devices commonly used in cardiopulmonary resuscitation (CPR) can, although rarely, lead to severe barotrauma. In this report, we describe a case of pulmonary barotrauma that appeared to be related to the "locking" of the "Ambu" bag's one-way valve in the inspiratory position during routine CPR.(Au)

Work site heart health promotion and practice: a pilot project of the Heart Foundation of Barbados

The workplace has long been recognised as an important setting in which to promote the practice of healthy living since most individuals spend more than one-third of their day in such situations which might be considered a "captive environment". The Heart Foundation of Barbados, aware of the significantly high prevalence of lifestyles related illnesses and the opportunities and potential for effecting positive change in the workplace, embarked on a worksite heart pilot project aimed at determining the feasibility of establishing such a programme in Barbados and determining its impact and effect on health practices of workers in the workplace and elsewhere. The study was conducted among the staff of a local professional services firm. It consisted of risk factor screening of staff members, teaching of and certification in Cardiopulmonary Resuscitation (CPR), and facilitating regular related activities. Two years after the initiation of the project an anonymous knowledge, attitudes and practice questionnaire was administered to participants. 116 (88 percent) members of staff was taught and certified in CPR, and a further 3 persons were trained and certified as CPR instructors. Anthropometric and blood pressure measurements were performed on the 116 participants. Over the two years of the project the company developed a significantly enhanced health consciousness and profile, as evidenced by the formation of a health club, active participation in national healthy lifestyles activities and the conducting of a regular related seminars, lectures and associated and related activities. Finally, among those responding to the knowledge attitudes and practices survey 60 percent of 60 participants returning completed questionnaires reported a positive change in their lifestyle as a direct result of the programme. Among 63 percent there was an enhanced personal attitude to the company. 36 participants (60 percent), reported that they would provide assistance in an emergency situation, of which 64 percent expressed confidence in doing so, and 58 percent attributed their confidence to their involvement in the programme. Preliminary results suggest that the introduction and implementation of a work site heart health promotion and practice programme is acceptable to workers in Barbados, is feasible, and results in improvement of worker health attitudes and practices.(AU)