Resuscitation
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Comparative Study
Comparison of termination-of-resuscitation guidelines for out-of-hospital cardiac arrest in Singapore EMS.
Termination of resuscitation (TOR) in the field for out-of-hospital cardiac arrest (OHCA) can reduce unnecessary transport to hospital and increase availability of resources for other patients. ⋯ We found all three TOR guidelines to have high sensitivity and negative predictive value. However the specificity and transport rates varied greatly. Application of any TOR guidelines may be affected by local EMS and population factors which should be considered in any policy decision.
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Comparative Study
Efficacy of therapeutic hypothermia after out-of-hospital cardiac arrest due to ventricular fibrillation.
We investigated implementation and efficacy of mild therapeutic hypothermia in the treatment of out-of-hospital cardiac arrest due to ventricular fibrillation. ⋯ Therapeutic hypothermia is efficient in significantly improving survival and neurological outcome of out-of-hospital cardiac arrest with ventricular fibrillation. By using a simple method, it can be implemented easily and quickly, without side effects.
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To report prospectively the outcome from prehospital cardiac arrest according to the Utstein template in the city of Tampere, Finland, with special reference to those patients in whom resuscitation was not attempted. ⋯ The Tampere EMS system initiated resuscitation less frequently than reported from other EMS systems, but the reasons to withhold resuscitation seemed justified. The overall and Utstein's 'golden standard' survival rates were comparable with previous reports.
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Comparative Study
Is the inter-nipple line the correct hand position for effective chest compression in adult cardiopulmonary resuscitation?
Despite the new release of CPR guidelines, there was insufficient evidence for or against a specific hand position for manual chest compression in adults. Computed tomography (CT) images of the chest can demonstrate objectively the spatial relationship between the surface landmarks on the chest and the inner viscera underneath them. This study is designed to examine the spatial relationship between the inter-nipple line (INL) and the heart in order to determine the proper hand position for more effective CPR. ⋯ For more efficient and effective chest compression during CPR, compressing the sternum more caudally than the INL could be considered if it is not associated with the risk of increasing internal visceral injuries.
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This study describes the epidemiology of sudden cardiac arrest patients in Victoria, Australia, as captured via the Victorian Ambulance Cardiac Arrest Register (VACAR). We used the VACAR data to construct a new model of out-of-hospital cardiac arrest (OHCA), which was specified in accordance with observed trends. ⋯ The new model accounts for relationships among predictors of survival. These relationships indicate that interventions such as reduced response times and bystander CPR act in multiple ways to improve survival.