Resuscitation
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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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Sequential monophasic defibrillation reduces transthoracic impedance (TTI) and progressively increases current flow for any given energy level. The effect of sequential biphasic shocks on TTI is unknown. We therefore studied patients undergoing elective cardioversion using a biphasic waveform to establish whether this is a phenomenon seen in the clinical setting. ⋯ Sequential biphasic defibrillation decreases TTI in a similar manner to that seen with monophasic waveforms. The effect is likely during defibrillation during cardiac arrest by the quick succession in which shocks are delivered and the lack of cutaneous blood flow which limits the inflammatory response. The ability of biphasic defibrillators to adjust their waveform according to TTI is likely to minimise any effect of these findings on defibrillation efficacy.
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Multicenter Study
Rationale, development and implementation of the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest.
To describe the development, design and consequent scientific implications of the Resuscitation Outcomes Consortium (ROC) population-based registry; ROC Epistry-Cardiac Arrest. ⋯ We describe the rationale, development, design and future implications of the ROC Epistry--Cardiac Arrest. This paper will serve as the reference for subsequent ROC manuscripts and for the common data elements captured in both ROC Epistry--Cardiac Arrest and the ROC trials.
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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 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.