Resuscitation
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Multicenter Study Comparative Study
Cardiac arrest in the Emergency Department: a report from the National Registry of Cardiopulmonary Resuscitation.
Little is known about cardiac arrests (CA) in the Emergency Department (ED). The objective of this study was to determine the characteristics of ED CAs. ⋯ ED CAs have unique characteristics, and better survival and neurologic outcomes compared to other hospital locations. Primary ED CAs have a better chance of survival to discharge than recurrent events. Traumatic ED CAs have worse outcomes than non-traumatic CA.
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Comparative Study
Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Singapore.
Chest compression only cardiopulmonary resuscitation (CC-CPR) without ventilation has been proposed as an alternative to standard cardiopulmonary resuscitation (CPR) for bystanders. However, there has been controversy regarding the relative effectiveness of both of these techniques. We aim to compare the outcomes of cardiac arrest patients in the cardiac arrest and resuscitation epidemiology study who either received CC-CPR, standard CPR or no bystander CPR. ⋯ We found that patients were more likely to survive with any form of bystander CPR than without. This emphasises the importance of chest compressions for OHCA patients, whether with or without ventilation.
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Comparative Study
Comparison of different flow-reducing bag-valve ventilation devices regarding respiratory mechanics and gastric inflation in an unprotected airway model.
Gastric inflation (GI) is a significant issue when ventilation is performed on unprotected airways. ⋯ Lowering GI by pressure-flow reduction may result in lower TV depending on the device used. Lowest GI resulted from R ventilation. This may be explained by the specific pressure/time or flow/time patterns achieved by use of this device.
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Gaining hemostatic control of vascular injuries sustained in combat using topical agents remains a challenge. We previously developed a new hemostatic agent consisting of a granular combination of a smectite mineral and a superabsorbent polymer (WoundStattrade mark; WS) which demonstrated the ability to stop high pressure bleeding. We have since modified WS to contain only the smectite mineral and compared the performance of WS to QuikClot'strade mark zeolite granules (QCG) in a lethal vascular injury model. ⋯ WS consisting of just the smectite mineral was superior to QCG tested in this model. Additional study is warranted to determine its potential for use in combat and civilian trauma.
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To evaluate how often an ambulance crew reports abnormal breathing among patients who are found deeply unconscious but without having suffered a cardiac arrest. ⋯ Signs of abnormal breathing among comatose patients with no cardiac arrest appear to be relatively common. This therefore increases the risk of starting cardiopulmonary resuscitation (CPR) in such patients, which is in accordance with the present CPR guidelines for the lay person. Whether this might do harm to such patients is not known.