Resuscitation
-
The factors influencing the decision to initiate resuscitation in prehospital cardiac arrest patients encountered in bradyasystole due to presumed heart disease were studied. For this purpose, the characteristics and circumstances of arrest of the patients encountered in asystole and electromechanical dissociation, seen by a physician-staffed prehospital emergency care unit in a tiered emergency medical system, were reviewed. During the study period, resuscitation was initiated in 83 bradyasytolic patients. ⋯ For the patients with a witnessed arrest, the delay before treatment was initiated also affected the decision. Successful resuscitation and survival of the patients was similar to earlier reports. The results provide guidelines in the decision making of initiation of resuscitation when developing our emergency care system into one with non-physicians as advanced life support providers.
-
Comparative Study
Measuring cardiopulmonary resuscitation performance: a comparison of the Heartsaver checklist to manikin strip.
Both checklists and recording manikin strips (strips) are used for evaluation of cardiopulmonary resuscitation (CPR) performance. To examine their relationship, we simultaneously evaluated single rescuer CPR of 255 subjects using both checklists and strips. For Group 1 (N = 192; general public tested in Heartsaver course) we compared the total number of initial ventilations and compressions judged to be correct by checklists with those judged to be correct by strips. ⋯ The most common disagreements were with performances evaluated as correct by checklist but not by strip. Therefore, the current checklist may be a poor instrument for measuring CPR. More accurate evaluation should improve learning and therefore improve outcome following cardiac arrest.
-
Comparative Study
Clinical experience with three different defibrillators for resuscitation of out of hospital cardiac arrest.
Three defibrillators, one manual and two different semiautomatic, were prospectively compared during a one year period for out-of-hospital use by ordinary ambulance personnel with short additional training. Eighty-three cardiac arrest patients were treated with one of two different semiautomatic defibrillators and 26 by an ordinary manual defibrillator. Twenty-nine were found in ventricular fibrillation. ⋯ There were no differences in conversion rate or in the clinical outcome between the three defibrillators tested. Both semiautomatic defibrillators tested seemed to be safe, reliable and cost-effective. The low survival rate found is most certainly due to a long ambulance delay.