Resuscitation
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This article will describe the access to, and delivery of, emergency medical care in the United Kingdom. We describe how UK Ambulance Services respond to emergency calls and how UK Emergency Departments are configured to provide emergency clinical care. Ambulance technician and paramedic training and clinical skill mix is outlined and UK emergency medicine training and the involvement of doctors in prehospital care is highlighted. We describe the strengths and weaknesses of current Emergency Medical Systems (EMS) in the UK and comment on future areas for improving and developing emergency patient care.
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Randomized Controlled Trial Comparative Study Clinical Trial
CPREzy: an evaluation during simulated cardiac arrest on a hospital bed.
CPREzy is a new adjunct designed to improve the application of manual external chest compressions (ECC) during cardiopulmonary resuscitation (CPR). The aim of this study was to determine the effect of using the CPREzy device compared to standard CPR during the simulated resuscitation of a patient on a hospital bed. Twenty medical student volunteers were randomised using a cross over trial design to perform 3 min of continuous ECC using CPREzy and standard CPR. ⋯ This was due to a higher number of low compressions (26% of total compressions for CPREzy versus 1% for standard CPR, P < 0.001). In conclusion, CPREzy was associated with significant improvements in ECC performance. Further animal and clinical studies are required to validate this finding in vivo and to see if it translates to an improvement in outcome in human victims of cardiac arrest.
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Multicenter Study
Long-term outcome of paediatric cardiorespiratory arrest in Spain.
To analyse the final outcome of cardiorespiratory arrest (CRA) in children and the neurological and functional state of survivors at 1 year. ⋯ Prognosis of CRA in children continues to be poor in terms of survival but quite good in terms of neurological and functional status among survivors. Additional strategies and efforts are needed to improve the short-term prognosis of paediatric CRA. However, the long-term outcome of survivors is reassuring.
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Practice Guideline Guideline
Cardiopulmonary resuscitation standards for clinical practice and training in the UK.
The Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society and the Resuscitation Council (UK) have published new resuscitation standards. The document provides advice to UK healthcare organisations, resuscitation committees and resuscitation officers on all aspects of the resuscitation service. It includes sections on resuscitation training, resuscitation equipment, the cardiac arrest team, cardiac arrest prevention, patient transfer, post resuscitation care, audit and research. ⋯ The practice of resuscitation should be audited to maintain and improve standards of care. A do not attempt resuscitation (DNAR) policy should be compiled, communicated to relevant members of staff, used and audited regularly. Funding must be provided to support an effective resuscitation service.
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Comparative Study
Should there be a change in the teaching of airway management in the medical school curriculum?
To evaluate the use of the Laryngeal Mask Airway (LMA), the oesophageal-tracheal combitube (ETC) and the tracheal tube (TT) by medical students, with a view to recommend changes to the medical school curriculum. ⋯ The use of the TT is difficult and the skills acquired by the medical students deteriorate significantly over time. The LMA and the ETC seem to have an advantage over the TT in that they are more easily learnt and the skills better retained. It is recommended that these alternative devices be included in the medical school curriculum for airway management.