[EUROPEAN RESUSCITATION COUNCIL GUIDELINES FOR RESUSCITATION 2015].

Adult basic life support and automated external defibrillation ­ Interactions between the emergency medical dispatcher, the bystander who provides CPR and the timely deployment of an AED is critical. All CPR providers should perform chest compressions, those who are trained and able should combine chest compressions and rescue breaths in the ratio 30:2. Defibrillation within 3­5 min of collapse can produce survival rates as high as 50­70%. Adult advanced life support ­ Continued emphasis on minimally interrupted high-quality chest compressions, paused briefly only to enable specific interventions, including interruptions for less than 5 s to attempt defibrillation. Use of self-adhesive pads for defibrillation. Waveform capnography to confirm and continually monitor tracheal tube placement, quality of CPR and to provide an early indication of return of spontaneous circulation. Cardiac arrest in special circumstances ­ Special causes: hypoxia; hypo-/hyperkalemia, and other electrolyte disorders; hypo-/hyperthermia; hypovolemia; tension pneumothorax; tamponade; thrombosis; toxins. Special environments are specialised healthcare facilities, commercial airplanes or air ambulances, field of play, outside environment or the scene of a mass casualty incident. Special patients are those with severe comorbidities and with specific physiological conditions. Post resuscitation care is new to the ERC Guidelines. Targeted temperature management remains, now aiming at 36°C instead of the previously recommended 32 ­ 34°C. Pediatric life support ­ For chest compressions, the lower sternum should be depressed by at least one third the anterior-posterior diameter of the chest (4 cm for the infant and 5 cm for the child). For cardioversion of a supraventricular tachycardia (SVT), the initial dose has been revised to 1 J kg­1. Resuscitation and support of transition of babies at birth ­ For uncompromised babies, a delay in cord clamping of at least one minute from the complete delivery of the infant, is now recommended for term and preterm babies. Tracheal intubation should not be routine in the presence of meconium and should only be performed for suspected tracheal obstruction. Ventilatory support of term infants should start with air. Acute coronary syndrome (ACS) ­ Pre-hospital recording of a 12-lead electrocardiogram (ECG) is recommended in patients with suspected ST segment elevation acute myocardial infarction (STEMI). Patients with acute chest pain with presumed ACS do not need supplemental oxygen unless they present with signs of hypoxia, dyspnea, or heart failure. In geographic regions where PCI facilities exist and are available, direct triage and transport for PCI is preferred to pre-hospital fibrinolysis for STEMI. First aid is included for the first time in the 2015 ERC Guidelines. Principles of education in resuscitation ­ Directive CPR feedback devices are useful for improving compression rate, depth, release, and hand position. Whilst optimal intervals for retraining are not known, frequent 'low dose' retraining may be beneficial. Training in non-technical skills is an essential adjunct to technical skills. The ethics of resuscitation and end-of-life decisions ­ Ethical principles in the context of patient-centered health care: autonomy, beneficence, non-maleficence; justice and equal access. The need for harmonisation in legislation, jurisdiction, terminology and practice still remains within Europe.

Detecting Baker's cyst: venous duplex scanning in ambulatory setting.

Popliteal cyst, also called Baker's cyst, is a popliteal fossa enlargement filled with synovial fluid. Baker's cysts can be symptomatic and cause considerable pathologies such as thrombophlebitis, compartment syndrome and even nerve entrapment. It is the most common nonvascular pathology seen in the popliteal fossa but clinically indistinguishable from deep vein thrombosis. The aim of the present study was to evaluate venous duplex scanning in detecting and distinguishing complicated Baker's cyst and deep vein thrombosis in outpatient setting. Medical records of all patients undergoing venous duplex scanning during 2008 and 2009 to rule out deep vein thrombosis were reviewed. Ten patients having undergone ultrasonography examination were found to have complicated Baker's cyst. Baker's cysts are a rather common condition. When presenting with swollen and painful calf, it is impossible to differentiate it from deep vein thrombosis by simple clinical examination. Venous duplex scanning of lower extremity was found to be a useful imaging modality for detection of Baker's cysts, deep vein thrombosis and associated pathology.

Ventilatory functions in Croatian population in comparison with European reference values.

AIM: To compare ventilatory capacity of Croatian population with the ventilatory function values predicted by conventional equations based on measurements among European populations. METHODS: Ventilatory capacity and respiratory symptoms were determined in a group of 2,482 healthy non-smokers (1,162 men and 1,320 women). The measurements were performed with a pneumotach spirometer. Maximum expiratory flow volume curves (MEFV) were registered, and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and flow rates at 50% (MEF50) and the last 25% of the vital capacity (MEF25) were recorded. Anthropometric data were also noted. Reference values were calculated using multiple linear regressions. RESULTS: Comparisons of our values with the prediction summary equations issued by the European Community for Steel and Coal (ECSC) and the European Respiratory Society (ERS) showed that healthy Croatians had consistently lower values of FVC (92.1-/+14.0% of the predicted volume for men and 86.2-/+11.7% for women) and FEV1 (93.7-/+14.8% of the predicted values for men and 95.3-/+13.1% for women), but higher values of MEF50 (107.8-/+30.1% of the predicted values for men and 103.4-/+22.8% for women) and MEF25 (117.3-/+41.0% of the predicted values for men and 117.9-/+34.0% for women) than the ECSC/ERS recommendations. The comparison was also made with the most commonly used North American reference standards based on populations of European origin, with similar findings. On the basis of the results of multiple linear regressions, we constructed prediction equations for ventilatory function in Croatian population. CONCLUSION: The ECSC/ERS recommendations are not satisfactory for the Croatian population.