Resuscitation
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Comparative Study
Early immunologic responses to trauma in the emergency department patients with major injuries.
A traumatic insult initiates an inflammatory cascade, which is a contributor to cell damage and could be a marker of injury severity. ⋯ We found evidence of a measurable early inflammatory response to trauma, using cytokine levels and lymphocyte subset counts.
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We sought to evaluate the association between three key out-of-hospital endotracheal intubation (ETI) errors and patient outcomes. ⋯ Out-of-hospital ETI errors are not associated with mortality. Failed out-of-hospital ETI increases the odds of pneumonitis.
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Randomized Controlled Trial
The impact of introducing medical emergency team system on the documentations of vital signs.
To study the rate of documentation of vital signs in the period before the occurrence of an adverse event or emergency team call and to measure the effect of introducing the medical emergency team (MET) system on the rate of such documentation. ⋯ The documentation of vital signs in the period before adverse events was commonly incomplete with a particular deficiency in the documentation of the respiratory rate. Introduction of a MET system was associated with improvement in the rate of documentation of vital signs.
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Comparative Study
Progressing from initial non-shockable rhythms to a shockable rhythm is associated with improved outcome after out-of-hospital cardiac arrest.
Cardiac arrest patients with initial non-shockable rhythm progressing to shockable rhythm have been reported to have inferior outcome to those remaining non-shockable. We wanted to confirm this observation in our prospectively collected database, and assess whether differences in cardiopulmonary resuscitation (CPR) quality could help to explain any such difference in outcome. ⋯ Progressing from initial non-shockable rhythms to a shockable rhythm was associated with improved outcome after OHCA. This occurred despite more pauses in chest compressions in the shockable group, probably related to defibrillation attempts.
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To review the characteristics and outcome of cardiopulmonary resuscitation in children at a rural hospital in Kenya. ⋯ Cardiopulmonary arrest after admission has a very poor prognosis in our hospital. Infectious diseases are the main underlying causes of arrest. If a child fails to respond to the basic tenements of PALS within 15 min then it is unlikely that further efforts to sustain life will be fruitful in hospitals where ventilation facilities are not present.