Resuscitation
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Cardiac arrest is responsible for significant morbidity and mortality, with consistently poor outcomes despite the rapid availability of prehospital personnel for defibrillation attempts in patients with ventricular fibrillation (VF). Recent evidence suggests a period of cardiopulmonary resuscitation (CPR) prior to defibrillation attempts may improve outcomes in patients with moderate time since collapse (4-10 min). ⋯ The performance of bystander CPR prior to defibrillation by EMS personnel is associated with improved survival among patients with time since collapse longer than 4 min but not less than 4 min. These data are consistent with the three-phase model of cardiac arrest.
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To determine the error of measurement in pulse oximetry with a decreased arterial perfusion and to identify a systolic pressure threshold for (1) initial detection and (2) a reliable reading of oxygen saturation. ⋯ Pulse oximetry is reliable with a systolic blood pressure > 80 mmHg. The lower the BP, the lower the pulse oximetry readings leading to a bias of up to -45%.
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Mild therapeutic hypothermia has shown to improve neurological outcome after cardiac arrest. Our study investigated the efficacy and safety of cold simple intravenous infusions for induction of hypothermia after cardiac arrest preceding further cooling and maintenance of hypothermia by specialised endovascular cooling. ⋯ Our results indicate that induction of mild hypothermia with infusion of cold fluids preceding endovascular cooling is safe and effective.
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Measuring different intervals during cardiopulmonary resuscitation is a key element of resuscitation performance. For accurate time measurements, the internal clocks of automated external defibrillator (AEDs) need to be synchronized with the dispatch centre time. ⋯ Synchronisation of AED clocks is not widespread in Finland. Instructions to synchronize have been issued in a minority of EMS systems. Despite this, time deviations are large, and erroneous times are recorded.