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Abstract

Aim.The aim of this literature review was to study medical staff knowledge about cardiopulmonary resuscitation for pregnant women.

Background.Cardiopulmonary resuscitation (CPR) in pregnancy is a rare event. Although rare, CPR during pregnancy is very important, because saves the life of the mother and fetus. Knowledge of medical staff and their formal training on CPR in pregnancy are such factors affecting the maternal and fetal outcomes. Knowing the state of medical staff knowledge in this area will help recognize the existing gaps and plan for improvement.

Method.In this narrative review, databases such as Medline, Science direct, Ovid, Scopus, SID, Magiran and Barakat Knowledge Network System was used to data collection. Articles published between 2000-2016, were searched out by the keywords "cardiopulmonary resuscitation",‌"pregnancy", "knowledge","medical Staff", both inPersian and English. Inclusion criteria was content similarity to subject under study. 

Findings. Out of 20 retrieved papers, 4 cross- sectional analytical articles published between 2008-2012 was selected and reviewed for describing the state of medical staff knowledge on CPR in pregnancy. The knowledge of medical staff was in poor level in different areas such as proper pregnant patient positioning during CPR, sequence of bag- mask ventilation and intubation, defibrillation (application during pregnancy, paddle placement location, energy and considerations), the use of drugs and therapeutic doses and cesarean section in within 4-5 minutes following CPR failure.  

Conclusion.The knowledge of medical staff about CPR in pregnancy is poor. Establishing continuous educational course to improve their knowledge is recommended. 

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Abstract
Aim. This literature review investigates the role of ECMO in the management of pulmonary barotrauma in people with decompression sickness (DCS).
Background. As a result of change in the atmospheric pressure in sea depth, divers may experience life threatening conditions such as barotrauma in vital organs including the lungs. Delivering 100% oxygen is the immediate treatment in these situations. A modern technology for oxygen therapy and supporting vital organs in heart and lung failure is extracorporeal membrane oxygenation (ECMO).
Method. This review was conducted by searching out databases UpToDate, Google scholar, Elsevier, SID and Magiran between 1995-2016 by the following keywords: diver, diving, decompression sickness, decompression syndrome, lung injuries, respiratory disorders, pulmonary barotrauma, treatment, and ECMO, and their Persian equivalents.
Findings. Oxygen administration and prevention of severe complications caused by accumulation of nitrogen bubbles in the body is an important treatment in this DCS. Oxygenation by nasal cannula in early stage and hyperbaric oxygenation in sever conditions are common treatments. ECMO can remove nitrogen bubbles of the blood and body and decrease concentration of nitrogen in the blood, and furthermore, improves oxygenation.
Conclusion. To rescue and prevent death in DCS victims, it is required to consider appropriate measures by minimum side effects. To do so, veno-venous ECMO can be a safe technique. The studies conducted in this field are limited; therefore more studies about ECMO usage in DCS must be conducted.

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Abstract
Aim. The purpose of this study is to review new achievements in prevention and treatment of venous thromboembolism (VTE) in orthopedic surgeries.
Background.
Method. This is a comprehensive review of literature published between 1998-2017 about prevention and treatment of VTE in orthopedic surgeries that was conducted through searching scientific databases and search engines Ovid, Science Direct, Medline, Google Scholar, and PubMed using the English and Persian forms of the words Apixaban, Dabigatran, Heparin, orthopedic procedures, venous thromboembolism, and Fondaparinux. In total, 35 English papers and 10 Persian papers were found, out of which 25 papers were included in the review.
Findings. The risk of VTE is increased considerably during orthopedic surgeries. It is associated with important morbidities and also can increase mortality rate. Without prophylaxis, there is a noticeably increased risk of both venous and pulmonary embolism. Choosing a prophylactic pharmacologic agent depends on its efficacy and safety and also, on the presence of comorbidities and patient preferences.
Conclusion. The features of primary preferred primary prophylactic method is easy management safety, effectiveness with limited or no need for laboratory observation, and cost effectiveness. The use of prophylactic anticoagulation in patient undergoing major orthopedic surgeries considerably reduces the risk of VTE, but does not completely exclude it.