Ronald G. Pirrallo

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BACKGROUND A clinical observational study revealed that rescuers consistently hyperventilated patients during out-of-hospital cardiopulmonary resuscitation (CPR). The objective of this study was to quantify the degree of excessive ventilation in humans and determine if comparable excessive ventilation rates during CPR in animals significantly decrease(More)
BACKGROUND In a departure from the previous strategy of immediate defibrillation, the 2005 resuscitation guidelines from the American Heart Association-International Liaison Committee on Resuscitation suggested that emergency medical service (EMS) personnel could provide 2 minutes of cardiopulmonary resuscitation (CPR) before the first analysis of cardiac(More)
CONTEXT Laboratory studies suggest that in the setting of cardiac ischemia, immediate intravenous glucose-insulin-potassium (GIK) reduces ischemia-related arrhythmias and myocardial injury. Clinical trials have not consistently shown these benefits, possibly due to delayed administration. OBJECTIVE To test out-of hospital emergency medical service (EMS)(More)
The pre-hospital care provided by emergency response systems will have an effect on the outcome of patients who have sustained an out of hospital cardiac arrest. This study compares the results of resuscitation in two centres, one in the UK (Edinburgh) and the other in the USA (Milwaukee), and examines the demographics in both centres. An overall greater(More)
Luxatio erecta, or inferior shoulder dislocation, is a rare form of shoulder dislocation. The case of a patient presenting with bilateral luxatio erecta, which was initially felt by EMS personnel to be an hysterical reaction, is discussed. An awareness of this rare entity, the potential-associated musculoskeletal and neurovascular injuries, and the proper(More)
INTRODUCTION Recent data suggest that generation of negative intrathoracic pressure during the decompression phase of CPR improves hemodynamics, organ perfusion and survival. HYPOTHESIS Incomplete chest wall recoil during the decompression phase of standard CPR increases intrathoracic pressure and right atrial pressure, impedes venous return, decreases(More)
OBJECTIVE To compare cardiopulmonary resuscitation (CPR) with a compression to ventilation (C:V) ratio of 15:2 vs. 30:2, with and without use of an impedance threshold device (ITD). DESIGN Prospective randomized animal and manikin study. SETTING Animal laboratory and emergency medical technician training facilities. SUBJECTS Twenty female pigs and 20(More)
BACKGROUND Ambulance crashes have become an increasing source of public concern. Emergency medical services directors have little data to develop ambulance operation and risk management policies. OBJECTIVE To describe fatal ambulance crash characteristics, identifying those that differentiate emergency and nonemergency use crashes. METHODS This was a(More)
OBJECTIVE To assess whether advanced age is an independent predictor of survival to hospital discharge in community-dwelling adult patients who sustained an out-of-hospital cardiac arrest in a suburban county. METHODS A prospective cohort study was conducted in a suburban county emergency medical services system of community-dwelling adults who had an(More)