Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Arterial blood-gases with 500- versus 1000-ml tidal volumes during out-of-hospital CPR.
The correct tidal volume during cardiopulmonary resuscitation (CPR) is presently debated. While the European Resuscitation Council (ERC) and American Heart Association (AHA) previously recommended a tidal volume of 800-1200 ml, the ERC has recently reduced this to 400-600 ml. In a prospective, randomised study of 17 non-traumatic out-of-hospital cardiac arrest patients intubated and mechanically ventilated 12 min(-1) with 100% oxygen, we have therefore compared arterial blood gases generated with tidal volumes of 500 and 1000 ml. ⋯ We conclude that arterial normocapnia is not achieved with either tidal volume during advanced life support with non-rebreathing ventilation at 12 min(-1). What ventilation volume is required for CO(2) removal and oxygenation during basic life support with mouth-to-mouth ventilation cannot be extrapolated from the present data. In that situation the risk of gastric inflation, regurgitation and aspiration must also be taken into account.
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To report paediatric in-hospital cardiac arrest data according to Utstein style and to determine the effectiveness of cardiopulmonary resuscitation (CPR) in hospitalized children. ⋯ In-hospital cardiopulmonary resuscitation was shown to be an uncommon event in children; the survival rate was similar to earlier studies.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomised controlled trials of staged teaching for basic life support. 1. Skill acquisition at bronze stage.
We have investigated a method of teaching community CPR in three stages instead of in a single session. These have been designated bronze, silver, and gold stages. The first involves only opening of the airway and chest compression with back blows for choking, the second adds ventilation in a ratio of compressions to breaths of 50:5, and the third is a conversion to conventional CPR. ⋯ Average performed rates were similar in the two groups, but more in the conventional group compressed too slowly whereas more in the bronze group compressed too rapidly. Observations were made for only three cycles of compression, but extrapolating these to the 8 min often considered a watershed for chances of survival for victims of cardiac arrest, an average of 308 compressions would be expected from those using conventional CPR compared with 675 for those using bronze level CPR. The implications of this difference are discussed.
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Biography Historical Article
Charles Augustus Leale and the resuscitation of Abraham Lincoln.