Resuscitation
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Since nursing staff in the hospital are frequently the first to witness a cardiac arrest, they may play a central role in the effective management of in-hospital cardiac arrest. In this retrospective study the first 500 in-hospital cardiac arrests in non-monitored areas, which were treated initially by nursing staff equipped with automated external defibrillators (AEDs) are reported. ⋯ This observational study supports the concept of hospital-wide first responder resuscitation performed by nursing staff before the arrival of the CPR-team. Among these patients survival rate was higher in those with VF/VT defibrillated at an early stage. Consequently, it may be assumed that patients may die unnecessarily due to sudden cardiac arrest if proper in-hospital resuscitation programmes are not available.
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Outcome after cardiac arrest is known to be influenced by immediate access to resuscitation. We aimed to analyse the location of arrest in relation to the prognostic value for outcome. ⋯ Cardiac arrest in a public location is independently associated with a better outcome.
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The objective of the study was to assess the effect of protocol compliance to the accuracy of cardiac arrest (CA) identification by the dispatchers. ⋯ A high identification rate of CAs seems to be achievable despite poor protocol compliance by dispatchers.
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A 42-year-old male underwent a total hip arthroplasty under subarachnoid anaesthesia with intrathecal bupivacaine and diamorphine. Shortly after the start of surgery, he suffered an allergic reaction that, at first, was difficult to distinguish from the recognised side-effects of intrathecal diamorphine. ⋯ Skin prick testing several weeks later identified diamorphine as the likely causative agent, a drug overlooked initially as a potential cause. We believe this is the first report of intrathecal diamorphine causing anaphylaxis.