Resuscitation
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Biography Historical Article
Resuscitation great. Joseph O'Dwyer and laryngeal intubation for croup.
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Review
Near death experiences, cognitive function and psychological outcomes of surviving cardiac arrest.
Cardiac arrest is associated with a number of cognitive processes as well as long term psychological outcomes. Recent studies have indicated that approximately 10-20% of cardiac arrest survivors report cognitive processes, including the ability to recall specific details of their resuscitation from the period of cardiac arrest. ⋯ There have also been numerous studies that have indicated that although the quality of life for cardiac arrest survivors is generally good, some are left with long term cognitive impairments as well as psychological sequelae such as post-traumatic stress disorder. This paper will review near death experiences, cognitive function and psychological outcomes in survivors of cardiac arrest.
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The primary aim was to derive a new termination of resuscitation (TOR) clinical prediction rule for advanced life support paramedics (ALS) and to measure both its pronouncement rate and diagnostic test characteristics. Secondary aims included measuring the test characteristics of a previously derived and published basic life support termination of resuscitation (BLS TOR) clinical prediction rule [Morrison LJ, Visentin LM, Kiss A, et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med 2006;355(5):478-87] on the same cohort of patients for comparison purposes. ⋯ Cardiac arrest patients may be considered for prehospital ALS TOR when there is no ROSC prior to transport, no shock delivered, no bystander CPR and the arrest was not witnessed by bystanders or EMS. A single EMS termination clinical prediction rule for all levels of providers would be optimal for EMS systems to implement. Prospective evaluation of the ALS TOR clinical prediction rule in the hands of ALS providers will be required before implementation.
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Randomized Controlled Trial Comparative Study
Influence of air-purifying respirators on the simulated first response emergency treatment of CBRN victims.
Medical first responders and emergency room personnel potentially are threatened by exposure to primary or secondary intoxication by chemical, biological, radiological or nuclear (CBRN) substances. The impact of personal respiratory protection by air-purifying respirators on the performance of resuscitation requires evaluation. This will help to improve major incident planning and measures for protecting medical staff. ⋯ Modern personal respiratory protection has only a negligible effect in the delay on the short term treatment during well defined simulated scenarios with a single CBRN casualty. Furthermore, air-purifying respirators with panoramic visors seem to allow a better orientation for medical first responders during simulated resuscitation.