What is the Appropriate Level of Electrocardiography Education Needed for Emergency Medical Technicians (EMT) Students?

PURPOSE: Assess the appropriate level of electrocardiography (EKG) education that should be incorporated into the curriculum of emergency medical technician (EMT) students. METHODS: Consensus by EMT professors and emergency medicine specialists was obtained using two rounds of the Delphi survey. The questionnaire consisted of 70 items; 12 related to demographic information, 8 related to general interpretation of EKG, 26 related to interpretation of arrhythmia, 20 related interpretations of structural anomaly, infarction and systemic disease, and 4 related to interpretation of EKG findings used for advanced cardiac life support. We considered consensus to be agreement of greater than 7 of 9 (66.7%). RESULTS: 59 and 24 subjects were included in the first and second rounds of the Delphi survey, respectively. The response rate was 59% for the first round and 40.7% for the second round. Of 70 items, 40 items came to a consensus by the panel. All items related to interpretation of EKG and advanced cardiac life support and most (10 of 12) items related to basic content were felt to be important by both EMT professors and emergency medicine specialists. However, for items related to arrhythmia and related to structural anomaly, infarction and systemic disease, less than half of the items examined were felt to be necessary in the curriculum of EMT students (12 of 26 and 6 of 20). CONCLUSION: We identified 40 items that should be included into the EKG curriculum of EMT students. These findings should be used to create more effective educational programs for EMT students.

Ultrastructure and Development of Heart Wall of Zebrafish (Danio rerio) / 체질인류학회지

Light and electron microscopic obserbations of developing heart wall of zebrafish, which has been recently used for developmental studies of many organs, were performed. Heart tissue was obtained from adult and 24, 48 and 72 hour embryos of zebrafish. Heart wall of adult zebrafish was composed of 3 typical layers, endocardium, myocardium and epicardium, as ones of other vertebrates. Heart wall of 24 hour embryo was composed of primitive myocytes. Myofibrils in myocytes at this period was found as assembly of myofilaments, 500~1,000 nm sized and 5~10 layered. Heart of 48 hour embryo has ventricle and atrium. Ventricular wall of was composed of endocardium, myocardium and incomplete epicardium. Atrial wall at 48 hour embryo was composed of endocardium and myocardium. Development of myocytes in ventricle was earlier than those of atrium, and myofibrils with Z disc were found first at 48 hour embryo. Heart wall of 72 hour embryo was morphologically similar to that of 48 hour embryo, but development of myocytes was more progressed. Specific atrial granules of 100~200 nm size appeared very rarely at 24 hour embryo and its numbers increased gradually at 48 and 72 hour embryos in myocytes of atrium as well as the ventricle. Specific atrial granules were consider as ones containing atrial natriuretic peptide (ANP).

On the Surgical Treatment of Ruptured Intracranial Aneurysms with Deliberate Hypotensive Anesthesia

13 cases of intracranial Aneurysm were obliterated intracranially with Heifetz clip under Halothane /O2 Deliberate Hypotensive anesthesia. Deliberate hypotension in the surgery of intracranial aneurysm is used to diminish bleeding and render an aneurysmal sac slack to make clipping easy. Herein is presented a review of clinical experience of deliberate hypotension in conjunction with postural drainage. Clinical investigation has shown that this method offers a wider margin of safety. All factors stressed again the needs for careful, adequate and ideal clippage of the neck of aneurysm preferably with the use of Heifetz clip. Deliberate hypotension and adequate clippage of the neck of aneurysm subsequently allowed a favorable clinical result with an operative mortality by 7.7%.