Resuscitation
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A recently published study has shown that survival after out-of-hospital cardiac arrest (OHCA) in Göteborg is almost three times higher than in Stockholm. The aim of this study was to investigate whether in-hospital factors were associated with outcome in terms of survival. ⋯ An almost 2-fold difference in survival after OHCA between Stockholm and Göteborg appears to be associated with pre-hospital factors only (predominantly in form of prolonged intervals in Stockholm), rather than with in-hospital factors or patient characteristics.
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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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Randomized Controlled Trial
Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: The American Airlines Study.
A head-to-head trial was conducted to compare laypersons' long-term retention of life-saving psychomotor and cognitive skills learned in the traditional multi-hour training format for basic cardiopulmonary resuscitation and automated external defibrillator use to those learned in an abbreviated (30 min) course. ⋯ Using innovative learning techniques, 30-min cardiopulmonary resuscitation and automated external defibrillator training is as effective as traditional multi-hour courses, even after 6 months. Thirty-minute courses should decrease labor intensity, demands on resources, and time commitments for cardiopulmonary resuscitation courses, thus facilitating more widespread and frequent retraining.
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To assess the effect of a Medical Emergency Team (MET) service on patient mortality in the 4 years since its introduction into a teaching hospital. ⋯ Introduction of an Intensive Care-based MET in a university teaching hospital was associated with a fluctuating reduction in post-operative surgical mortality which was already apparent during the education phase, but a sustained increase in the mortality of medical patients which was similarly already apparent during the education phase. The differential effects on mortality may relate to differences in the degree of disease complexity and reversibility between medical and surgical patients.