Resuscitation
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A prospective manikin-based observational study of telephone-directed cardiopulmonary resuscitation.
Bystander cardiopulmonary resuscitation (CPR) significantly improves the outcome from sudden cardiac arrest (SCA) and is therefore encouraged by offering telephone instructions to the bystander. The effectiveness of this technique was examined in a manikin-based study. ⋯ Few bystanders perform CPR satisfactorily and further work is necessary to improve the effectiveness of telephone CPR instructions.
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The aim of this prospective cohort study was to describe the outcome for patients with out-of-hospital cardiac arrest in Maribor (Slovenia) over a 4 year period using a modified Utstein style, and to investigate elementary knowledge of basic life support among potential bystanders in our community. ⋯ After OHCA in a physician-based prehospital setting in our region, the overall survival to discharge was 21%. The potential bystander in our community is generally poorly educated in performing CPR, but willing to gain knowledge and skills in BLS and to follow dispatchers instructions. Arrival time, witnessed arrest, bystander CPR, initial petCO2 and final petCO2 were significantly positively related with ROSC on admission and with survival. Prehospital data from this and previous studies provide strong support for a petCO2 of 1.33 kPa to be a resuscitation threshold in the field. In our opinion the initial value of petCO2 should be included in every Utstein style analysis.
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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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To characterize out-of-hospital cardiac arrest (OHCA) and factors that affect survival in a medium sized city that uses system status management for dispatch. ⋯ This study finds a 5% survival to 1 year among OHCA patients in Rochester, NY. A presenting rhythm of VF/VT and bystander CPR were associated with increased survival.