Resuscitation
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Comparative Study
Emergency echocardiography to detect pericardial effusion in patients in PEA and near-PEA states.
Emergency echocardiography (EM echo) has been proposed to assist in decision-making in patients with pulseless electric activity (PEA) or PEA-like states. We observed the value of EM echo by emergency physicians in detecting pericardial effusion in patients in PEA and near PEA states. ⋯ Emergency echocardiography performed by emergency physicians in patients in PEA or near PEA states can detect pericardial effusions with correctable etiologies versus true PEA with ventricular standstill.
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To clarify the incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrests (OHCA) with cardiac etiology in Osaka Prefecture, Japan, with a population of nearly 9 million according to the Utstein style. ⋯ The incidence of bystander-witnessed (OHCA) with cardiac etiology and VF or VT were remarkably low compared with those reported by other studies conducted in some areas of Europe or the USA.
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The introduction of the European Resuscitation Guidelines (2000) for cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) prompted the development of an up-to-date and reliable method of assessing the quality of performance of CPR in combination with the use of an AED. The Cardiff Test of basic life support (BLS) and AED version 3.1 was developed to meet this need and uses standardised checklists to retrospectively evaluate performance from analyses of video recordings and data drawn from a laptop computer attached to a training manikin. This paper reports the inter- and intra-observer reliability of this test. ⋯ The inter- and intra-observer reliability for the majority of the variables in the Cardiff Test of BLS and AED version 3.1 is satisfactory. However, reliability is less acceptable with respect to shaking when checking for responsiveness, initial check/clearing of the airway, checks for signs of circulation, time to first shock and performance of interventions in the correct sequence. Further research is required to determine if modifications to the method of assessing these variables can increase reliability.
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Comparative Study
Compared to angiotensin II, epinephrine is associated with high myocardial blood flow following return of spontaneous circulation after cardiac arrest.
Epinephrine (adrenaline) and vasopressin are used currently to improve myocardial blood flow (MBF) during cardiac arrest. Angiotensin II has also been shown to improve MBF during CPR. We explored the effects of angiotensin II or epinephrine alone, and the combination of angiotensin with epinephrine, on myocardial and cerebral blood flows in a swine model of cardiac arrest. ⋯ The combination of ANG and EPI did not improve MBF during cardiac arrest. Epinephrine may increase MBF compared with angiotensin II post-reperfusion.