Resuscitation
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It is essential to have a clear understanding of the present condition of cardiopulmonary resuscitation (CPR) training courses and the associated problems. The present study was performed to identify the current conditions of CPR training in Japanese high schools and the attitudes of students toward CPR. ⋯ Japanese high school students are reluctant to perform CC plus MMV, despite having received training. The present educational system in Japan has limitations in encouraging high school students to perform CC plus MMV.
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Measures of the ventricular fibrillation (VF) waveform may enable better allocation of cardiac arrest treatment by discriminating which patients should receive immediate defibrillation versus alternate therapies such as CPR. We derive a new measure based on the 'roughness' of the VF waveform, the Logarithm of the Absolute Correlations (LAC), and assess and contrast how well the LAC and the previously published scaling exponent (ScE) predict the duration of VF and the likelihood of return of spontaneous circulation (ROSC) under both optimal experimental and commercial-defibrillator sampling conditions. ⋯ The LAC is an improvement over the ScE because the LAC retains its prognostic characteristics at lower ECG sampling rates typical of current clinical defibrillators. Hence, the LAC may have a role in better allocating treatment in resuscitation of VF cardiac arrest.
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Comparative Study
Shock outcome prediction before and after CPR: a comparative study of manual and automated active compression-decompression CPR.
We report on a study designed to compare the relative efficacy of manual CPR (M-CPR) and automated mechanical CPR (ACD-CPR) provided by an active compression-decompression (ACD) device. The ECG signals of out-of-hospital cardiac arrest patients of cardiac aetiology were analysed just prior to, and immediately after, cardiopulmonary resuscitation (CPR) to assess the likelihood of successful defibrillation at these time points. The cardioversion outcome prediction (COP) measure previously developed by our group was used to quantify the probability of return of spontaneous circulation (ROSC) after counter-shock and was used as a measure of the efficacy of CPR. ⋯ However, a detailed statistical analysis carried out between the groups adjusted for pre-CPR value showed no significant difference between the two methods of CPR (p=0.20). Similarly, adjusting for length of CPR showed no significant difference between the groups. Secondary, subgroup analysis of the ECG according to the length of time for which CPR was performed showed that both types of CPR led to an increase in the likelihood of successful defibrillation after increasing durations of CPR, however results were less reliable after longer periods of continuous CPR.
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Controlled Clinical Trial
To see or not to see--better dispatcher-assisted CPR with video-calls? A qualitative study based on simulated trials.
Video communication through mobile telephone is now available in many parts of the world. We ask how mobile phone video-calls compares with traditional phone calls for dispatcher-assisted cardiopulmonary resuscitation (T-CPR). ⋯ Video communication can improve the dispatchers' understanding of the rescuer's situation, and the assistance they provide.
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We have observed consistent hemodynamic patterns after restoration of spontaneous circulation (ROSC) after ventricular fibrillation (VF) cardiac arrest. We sought to characterize the time-course of these patterns, and to determine whether these differed based on duration of the VF insult. ⋯ There are two distinct phases of hemodynamic change after resuscitation of VF. The first phase is a brief hyperdynamic phase. The second phase is either stabilization or cardiovascular collapse. When VF is brief, blood pressures often return to normal without exogenous support. When VF was prolonged animals were rescued with exogenous pressor. Healthcare providers should be prepared to provide pressor support for patients having ROSC after prolonged VF.