Resuscitation
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Randomized Controlled Trial Comparative Study
Out-of hospital advanced life support with or without a physician: effects on quality of CPR and outcome.
The presence of physicians is believed to facilitate optimal management of out-of-hospital cardiac arrest, but has not been sufficiently documented. ⋯ Survival after out-of-hospital cardiac arrest was not different for patients treated by the PMA and non-PMA in our EMS system.
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Survival following out-of-hospital cardiac arrest (OHCA) continues to be disappointingly low world-wide, despite advances in technology and international guidelines for resuscitation. Few cities or emergency medical service (EMS) agencies report patient outcomes after OHCA. Among those who do, survival from witnessed VF ranges from 7.7% to 39.9%, with only a few cities reporting rates higher than this. We report outcomes and incidence of VF OHCA over 18 years in a medium-sized city incorporating an aggressive approach to OHCA. ⋯ High survival from witnessed VF OHCA (46.3%) was achieved during the study period. Rapid response, and therefore rapid defibrillation, was the major contributor to survival.
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Comparative Study
Extubation force: a comparison of adhesive tape, non-adhesive tape and a commercial endotracheal tube holder.
This study compares adhesive tape, non-adhesive tape and a commercial endotracheal tube holder in terms of the force required to extubate endotracheal tubes from a cadaver. ⋯ Although the Lillehei method provided the greatest resistance to tube dislodgement, it may not be ideal for the prehospital or emergency department context. The Thomas Tube Holder was quick and effective and may provide a good compromise in these environments, although once time is no longer important, clinicians may elect to revert to the Lillehei method which provides greater security.
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Randomized Controlled Trial Comparative Study
Effects of AED device features on performance by untrained laypersons.
Our study evaluates the impact of features of automated external defibrillators (AEDs) on the performance and speed of untrained laypersons to deliver a shock and initiate CPR after a shock. ⋯ Most untrained laypersons were successful in delivering a shock. Device features had the most impact on these functions: ability and time to power-on device, adequacy of pad position and initiation of CPR.