Resuscitation
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The recurrence rate of lethal cardiac events after the survival of a primary cardiac arrest in patients not having received an implantable cardioverter defibrillator (ICD) is investigated. ⋯ Cardiac arrest survivors without an apparent indication for an ICD have a high risk of suffering from a re-arrest of cardiac origin.
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Randomized Controlled Trial Clinical Trial
Effectiveness of ventilation-compression ratios 1:5 and 2:15 in simulated single rescuer paediatric resuscitation.
Current guidelines for paediatric basic life support (BLS) recommend a ventilation-compression ratio of 1:5 during child resuscitation compared with 2:15 for adults, based on the consensus that ventilation is more important in paediatric than in adult BLS. We hypothesized that the ratio 2:15 would provide the same minute ventilation as 1:5 during single-rescuer paediatric BLS due to the reduced time required to change between ventilations and compressions. Fourteen lay rescuers were trained with both ratios and thereafter performed single rescuer BLS for approximately 4 min with each of the two ratios in random order on a child-sized manikin with a built-in respiratory monitor. ⋯ Nearly all chest compressions were within acceptable limits for depth and place with both methods, but the mean number of chest compressions per minute was 48+/-15% greater with ratio 2:15. In conclusion, there was no difference in ventilation, but nearly one and a half times as many compressions with a ratio of 2:15 than 1:5 for lay rescuers during single rescuer paediatric CPR. In order to simplify CPR training for laypersons, we recommend a 2:15 ratio for both single- and two-person, adult and paediatric layperson BLS.
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Cardiopulmonary resuscitation (CPR) is widely recognized as an essential part of the medical response to cardiac arrest. Traditional ('basic') CPR has remained essentially unchanged for 40 years despite major problems with training and performance, and survival rates from out-of-hospital cardiac arrest remain disappointingly low, despite massive resources devoted to CPR training and public awareness. ⋯ The article received little notice at the time; however, the method of prone CPR merits further consideration based on a number of subsequent supporting studies and case reports. Prone CPR may represent a superior alternative to traditional CPR; research into its effectiveness should be given high priority.