Resuscitation
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We assessed the familiarity of the general public with automated external defibrillators (AEDs) and their willingness to use them. ⋯ Although a substantial number of people in this setting were willing to use an AED, education regarding legal liability and proper use of the machines increased the reported likelihood of use. Further public education may be necessary to provide optimally effective public access defibrillation programs.
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To determine if attendance at a Resuscitation Council (UK) immediate life support (ILS) course influenced the skill deployment of nurses at a subsequent cardiac arrests. ⋯ ILS training alone may be insufficient to increase deployment of these skills by nurses who are not cardiac arrest team members. A more supportive approach, involving individual coaching of these individuals may need to be considered.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Measuring survival rates from sudden cardiac arrest: the elusive definition.
Measuring survival from sudden out-of-hospital cardiac arrest (OOH-CA) is often used as a benchmark of the quality of a community's emergency medical service (EMS) system. The definition of OOH-CA survival rates depends both upon the numerator (surviving cases) and the denominator (all cases). ⋯ Reported OOH-CA rates and survival rates vary widely, depending upon the definitions applied to events. Rigorous assessment of treatments applied to improve survival can be obscured by inappropriate definitions. Large-scale randomized interventions designed to improve survival from OOH-CA can be evaluated based upon the absolute numbers of patients surviving, rather than a change in the proportion surviving.
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Research in patients with life-threatening illness such as cardiac arrest is challenging since they can not consent. The Food and Drug Administration addressed research under emergency conditions by publishing new criteria for exception from informed consent in 1996. We systematically reviewed randomized trials over a 10-year period to assess the impact of these regulations. ⋯ Fewer American cardiac arrest trials were published during the last decade, when federal consent requirements changed. Regulatory requirements for clinical trials may inhibit improvements in care and threaten public health.
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To determine whether antithrombin (AT) administration during cardiopulmonary resuscitation (CPR) increased cerebral circulation and reduced reperfusion injury. ⋯ In this experimental model of CPR, AT administration did not increase cerebral circulation or reduce reperfusion injury after ROSC.