Resuscitation
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Current Advanced Medical Priority Dispatch System (AMPDS) V.11.1 telephone instructions are limited in their ability to produce correctly performed basic life support. The current telephone instructions were modified in an attempt to improve areas of poor CPR performance. ⋯ The effective delivery of telephone-directed CPR to untrained bystanders is a complex process. Changing verbal instructions to improve the quality of CPR is not easy. Further work is urgently needed to strengthen this important link in the chain of survival.
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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.
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The 1-day immediate life support course (ILS) was started in the United Kingdom and adopted by the ERC to train healthcare professionals who attend cardiac arrests only occasionally. Currently, there are no reports about the ILS course from outside the UK. In this paper we describe our initial Italian experience of teaching ILS to nurses. We have also measured the impact that ILS has on the resuscitation knowledge of nurses. ⋯ We have reproduced the ILS course in Italy successfully. ILS teaching resulted in an improvement in resuscitation knowledge of the first group of nurses trained.
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The present study was undertaken to compare an animal model of electrically induced VF with ischemically induced VF. In a preponderance of models of cardiac arrest and resuscitation in intact animals, ventricular fibrillation (VF) is induced by an alternating current delivered directly to the epicardium or endocardium. Yet, the applicability of such animal models has been challenged for it is not an electrical current alone but rather a current generated in the ischemic myocardium that triggers VF. Accordingly, a potentially more clinically relevant model was investigated in which spontaneous VF followed acute myocardial ischemia. ⋯ A significant increase in the number of post-resuscitation premature ventricular beats and recurrent VF followed ROSC and a significantly greater number of shocks was required for restoration of spontaneous circulation (ROSC) after LAD occlusion. Nevertheless, early post-resuscitation myocardial dysfunction, neurological recovery and 72 h survival were indistinguishable between the two models.