Resuscitation
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A key component of out-of-hospital emergency care is the rapid response of trained providers with appropriate medical equipment. In some communities, law enforcement agents function as first responders to accomplish this goal. The purpose of this national survey was to assess the proportion of law enforcement agencies that provide medical care to determine the extent of care they provide, to identify how many use AEDs, and to assess the attitudes of agency leaders regarding their roles as medical first responders. ⋯ Based on this survey, law enforcement agents often serve as medical first responders. Nearly three quarters of responding agencies felt this role was appropriate. AEDs are now deployed much more frequently than indicated by a previous national study, but still less than one-third of law enforcement agencies carry AEDs as part of their standard response equipment.
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To evaluate the impact of decreased fluid resuscitation on multiple-organ dysfunction after severe burns. This approach was referred to as "permissive hypovolaemia". ⋯ Permissive hypovolaemia seems safe and well tolerated by burn patients. Moreover, it seems effective in reducing multiple-organ dysfunction as induced by oedema fluid accumulation and inadequate O2 tissue utilization.
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The unintentional print-out by two different software programmes of the same resuscitation-related events stored on a data card of a Laerdal FR2-automated external defibrillator (AED), led to the discovery of flaws in the registration of the time line by one of the commercially available Laerdal software programmes. This observation stresses the need for a continuation of the medical supervision of AED projects, the close co-operation between clinicians and AED manufacturers, the well-controlled introduction of new devices and strict postmarket surveillance programmes.
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After successful cardiopulmonary resuscitation, acute ST-elevation myocardial infarction (STEMI) may be documented. We investigated the incidence and prognosis of patients admitted to our department between 1 January 2000 and 31 December 2004. Among 2393 consecutive patients with STEMI, 135 (5.7%) presented after a return of spontaneous circulation (ROSC). ⋯ Hospital survival among comatose patients was 51% and hospital survival with cerebral performance category (CPC) 1 or 2 was 29%. Accordingly, outcome of patients with STEMI who regain consciousness after ROSC and undergo primary PCI is comparable to patients without cardiac arrest. This is in contrast with comatose survivors who, despite aggressive reperfusion treatment, had a significantly worse outcome.