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Background: Current guidelines emphasize the assistance of the emergency dispatcher in bystander cardiopulmonary resusitation (CPR). Its quality, however, has varied across cases. Objective: To determine the effect of repetitive coaching by dispatchers using verbal encouragement on the quality of lay-rescuer CPR. Methods: We conducted a dispatch-assisted CPR (DACPR) simulation study. Participants with no CPR training within the previous year were assigned randomly to 1 of 2 DACPR simulations. One was the No Coaching Group: callers were told to perform CPR and the dispatcher periodically confirmed that the caller was performing CPR. The second group was the Coaching Group: the dispatcher repetitively coached, encouraged, and counted aloud using a metronome. Participants performed CPR for 2 min under instruction from the study dispatcher. Parameters including chest compression depth, rate, and chest compression fraction were recorded by video camera and CPR manikin. Results: Forty-nine participants 20 to 50 years of age were recruited, and 48 completed the simulation (Coaching Group, n = 27; No Coaching Group, n = 21). The chest compression fraction was higher in the Coaching Group (99.4% vs. 93.0%, p = 0.005) and no participants interrupted chest compression more than 10 s in this group. When comparing the average depth of each 30-s period in each group, the depth increased over time in the Coaching Group (40.9 mm, 43.9 mm, 44.1 mm, and 42.8 mm), while it slightly decreased in the No Coaching Group (40.6 mm, 40.1 mm, 39.4 mm, and 39.8 mm). Conclusions: Repetitive verbal encouragements augmented chest compression depth with less-hands off time. Continuous coaching by dispatchers can optimize lay-rescuer CPR., 博士（医学）・甲第852号・令和4年9月28日, © 2022 Elsevier Inc., © 2022 The Author(s). Published by Elsevier Inc.This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Background: There are few reports of chemical proctocolitis induced by transanal administration of alcohol. Case report: The patient was a 21-year-old male with no medical history. He transanally pumped 1.8 L of 35% alcohol, experienced melena and disturbance of consciousness, and was transported by ambulance to our hospital. Abdominal computed tomography and endoscopy findings indicated ischemic colitis. He was administered conservative treatment and discharged after 9 days of hospital stay. Conclusion: Reports on alcohol-induced chemical proctocolitis are rare. None of the reported cases involved perforation or required surgery, and all were resolved with conservative therapy, as observed in the study patient.

Background: Surgical site infection (SSI) is common following cranioplasty after decompressive craniectomy (DC). The aim of this study was to assess the risk of SSI following cranioplasty in terms of the preservation method of autogenous bone graft (ABG), comparing preservation in 80% ethanol versus the standard method of subcutaneous ABG preservation. Material and methods: The patients who underwent cranioplasty using ABGs after DC between 2008 and 2019 were retrospectively reviewed. SSIs were compared between patients whose ABG was preserved in 80% ethanol (group A) and those whose ABG was preserved subcutaneously (group B) using inverse probability of treatment weighting (IPTW) based on propensity scores to balance measurable confounders including elderly age, sex, expanded polytetrafluoroethylene, stroke, interval to cranioplasty, and diabetes mellitus. Results: Total number of 127 patients consisted of 56 in group A and 71 in group B. SSI after cranioplasty occurred in five patients each in groups A and B (8.9% vs. 7%, p = 0.748). IPTW analysis demonstrated that preservation in 80% ethanol was associated with a lower risk of SSI (odds ratio: 0.239, 95％ confidence interval: 0.0615–0.927, p = 0.039). Conclusion: The simple and less-invasive method of preserving ABGs in 80% ethanol for cranioplasty after DC might be potentially safe from an SSI perspective., 博士（医学）・乙第1526号・令和4年3月15日, © 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND licens(https://creativecommons.org/licenses/by-nc-nd/4.0/).

Hidetada Fukushima,1 Francesco Bolstad2 1Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City, Nara, Japan; 2Department of Clinical English, Nara Medical University, Kashihara City, Nara, JapanCorrespondence: Hidetada Fukushima Email hidetakarina@gmail.comAbstract: With each successive update of the cardiopulmonary resuscitation (CPR) guidelines, the role of dispatchers in sudden cardiac arrest (CA) has grown. Dispatchers instruct callers in how to perform CPR until the arrival of emergency medical service (EMS) professionals. This is widely known as telephone CPR (TCPR) or dispatch-assisted CPR (DACPR). Studies have shown the efficacy of TCPR in increasing the survival rate of sudden CA. The TCPR process, however, is challenging and needs to be constantly evaluated and refined in order to improve the survival rate of sudden CA victims throughout the world. In this review article, the current status, challenges, and future perspectives of TCPR are discussed with a view to providing a research foundation from which to launch further studies into the effective role of dispatchers in sudden CA.Keywords: out of hospital cardiac arrest, telephone cardiopulmonary resuscitation, emergency medical dispatcher