Resuscitation
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This paper presents the second part of the validated Cardiff test for one rescuer basic life support skills, based on observation of video recording combined with the Recording Resusci Anne printout (VIDRAP). The authors believe that this is a robust evaluation tool which is capable of assessing the potential value to a casualty of a simulated resuscitation. The adoption of a widely accepted test methodology would facilitate comparison of research in different centres, which is not possible at present.
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Brainstem auditory evoked responses (BAER) are routinely used to monitor brainstem function in hospitalized comatose patients. We used a rat model of cardiac arrest and resuscitation to explore the possibility that the BAER, monitored during and immediately after cardiopulmonary resuscitation (CPR), could be used to determine whether the CPR was effective in restoring brainstem blood flow. Long-Evans rats were subjected to 7 min of cardiac arrest, induced by chest compression under Ketamine anesthesia sufficient to mechanically prevent the heart from pumping blood and were then resuscitated using a standard CPR protocol. ⋯ If it was greater than 0.35 ms the rat died. This signal was used as a cue for intervention in three rats; two survived. Thus, in this preparation, the BAER provided a useful measure of CPR effectiveness, in time to permit successful intervention.
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The aim of the study was to evaluate whether mass-mailing of a 12-month wall calendar which focused on child and infant safety and first aid treatment had any educational effect on lay people. The calendar included algorithms for removal of a foreign body from the airways and infant and child CPR. The knowledge and skills in these procedures were tested in two groups using a previously validated check-list before and after the introduction of the calendar. ⋯ Whether the test persons had children 0-8 years old or not, did not affect the results. In conclusion the calendar had no educational effect when distributed by mail, but a safety campaign which included distribution of the calendar and a possibility to borrow a manikin had a positive influence on the first aid skills and knowledge of lay people. Mass mailing of CPR or other first aid material free-of-charge does not seem to further the goal of increasing the rate and proficiency of bystander interventions to save lives.
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The aim of the study was to develop a scoring system for outcome classification at the start of prehospital first tier resuscitation for patients with cardiac arrest from ventricular fibrillation (VF). We studied a consecutive sample of 100 out-of-hospital cardiac arrest patients, presenting with VF of presumed cardiac etiology on arrival of the first tier (in a two-tiered urban Emergency Medical Services system). The number of patients discharged was 29 ('survivors') and 71 died ('non-survivors'). ⋯ Using this index 79% of the survivors and 70% of the non-survivors could be classified correctly. Adding age to the formula increased the correct classification of survivors to 86 and 73% for the non-survivors. The survival index provides a research tool for the discrimination between potential survivors and non-survivors, which opens the possibility for the development of alternative treatment protocols in cardiac arrest.
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A study was designed to determine which paediatric trauma patients with no detectable vital signs are likely to benefit from cardiopulmonary resuscitation (CPR). ⋯ The overall survival rate of paediatric patients with cardiac arrest secondary to trauma is poor. Trauma patients in whom cardiac arrest is caused by respiratory arrest or by thoracoabdominal trauma in the hospital setting may have a chance of survival if a spontaneous circulation is rapidly restored with effective resuscitative measures.