Resuscitation
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Randomized Controlled Trial Multicenter Study
The relationship between shocks and survival in out-of-hospital cardiac arrest patients initially found in PEA or asystole.
To describe survival rates from out-of-hospital cardiac arrest for patients who present with pulseless electrical activity or asystole according to whether they remained in a non-shockable rhythm or converted to ventricular fibrillation and were shocked appropriately. ⋯ These results suggest that patients with cardiac arrest who develop VF during the course of treatment for initially observed pulseless electrical activity or asystole do not benefit from conventional approaches to treatment such as defibrillation. Further study is warranted to define the optimal treatment of this patient cohort.
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Biography Historical Article
Resuscitation great. The Holger Nielsen method of artificial respiration.
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Randomized Controlled Trial Multicenter Study
Retention of CPR skills learned in a traditional AHA Heartsaver course versus 30-min video self-training: a controlled randomized study.
Bystander CPR improves outcomes after out of hospital cardiac arrest. The length of current 4-h classes in cardiopulmonary resuscitation (CPR) is a barrier to more widespread dissemination of CPR training and older adults in particular are underrepresented in traditional classes. Training with a brief video self-instruction (VSI) program has shown that this type of training can produce short-term skill performance at least as good as that seen with traditional American Heart Association (AHA) Heartsaver training, although it is unclear whether there is comparable skill retention. ⋯ Retention of CPR skills was compared 2 months post-training for adults between 40 and 70 years old who had taken either a traditional Heartsaver CPR course or a 22-min video self-directed training course. Although performance declines occurred in the 2-month interval, self-trained subjects generally demonstrated CPR skill retention equivalent to that of Heartsaver-trained subjects, although for both groups skill decline on some measures reached the level of untrained controls.
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CPR quality is an important determinant of cardiac arrest outcome. Recent investigations have demonstrated that quality of clinical CPR is variable and often not in compliance with international consensus guidelines. The 2005 update of these guidelines included new recommendations for the measurement of resuscitation and CPR performance and the institution of measures to improve resuscitation care. Common definitions and reporting templates need to be established for the variables of CPR quality. This will allow for meaningful comparisons between treatment groups in clinical trials as well as a common system for quality improvement and documentation of this improvement. ⋯ In this report, we present the results from an international consensus working group to propose common definitions and criteria for reporting variables of CPR quality, based on the best available data for the importance of various CPR variables. The recommendations are discussed in light of the different purposes outlined above.