Resuscitation
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Drowning associated with hypothermia and cardiopulmonary resuscitation has a very poor prognosis. We report two such cases, where impossible oxygenation due to severe pulmonary oedema was treated with extracorporeal membrane-oxygenation (ECMO). Following cardiac arrest, mild therapeutic hypothermia for 24h was maintained as recommended, but subsequent rewarming precipitated additional pulmonary oedema. ⋯ Both patients survived with no neurological sequelae. We speculate that prolonged hypothermia was not only neuroprotective, but also minimized reperfusion injury including pulmonary oedema. Extension of hypothermia for several days seems safe and feasible in selected cases.
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Comparative Study
The approach to delayed resuscitation in paediatric cardiac arrest: A survey of paediatric intensivists in Canada.
To determine how long a period of having had no cardiopulmonary-resuscitation (CPR) (delay time) is considered to result in subsequent futile efforts at resuscitation. ⋯ A delay time of 15 [10-20] (range 5-30)min was considered futile for survival. This has implications for pronouncing death in donation after cardiac death.
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Comparative Study
Performing bystander CPR for sudden cardiac arrest: behavioral intentions among the general adult population in Arizona.
The odds of surviving an out-of-hospital cardiac arrest are significantly improved by the provision of bystander cardiopulmonary resuscitation (CPR), but many cardiac arrest victims do not receive it. The existing literature remains equivocal as to why people are unwilling to perform traditional CPR. This study's objectives were to determine the behavioral intentions of the general population in Arizona regarding performing bystander CPR and to assess the reasons for being unwilling to perform CPR. ⋯ Although our findings likely overestimate the proportion of individuals who would perform bystander CPR, the relative importance of the reasons for not performing CPR is informative. Based on the reasons reported, there is potential to change the CPR-related attitudes, beliefs, and skill levels of the general public to enhance the number of people willing and able to perform bystander CPR.
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To discuss challenges in representing resuscitation data from Utstein style reports and devices like defibrillators with focus on unified and efficient handling of variety of resuscitation research objectives. ⋯ A scheme for representing resuscitation data should combine essential information stored in different locations after a resuscitation attempt. The resulting representation should enable data analysis to enable studies of the relationship between therapy and patient response. As the complexity and amount of data generated during resuscitation efforts are ever increasing, the time is mature for using modern information technology tools to provide infrastructure for efficient data management and analysis to identify and meet future challenges in resuscitation data analysis.
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Comparative Study
Feasibility and reliability of remote assessment of PALS psychomotor skills via interactive videoconferencing.
This study determined inter-rater agreement between skill assessments provided by on-site PALS evaluators with ratings from evaluators at a remote site viewing the same skill performance over a videoconferencing network. Judgments about feasibility of remote evaluation were also obtained from the evaluators and PALS course participants. ⋯ Videoconferencing technology was shown to provide adequate spatial and temporal resolution for PALS evaluators at-a-distance from course participants to agree with ratings of on-site evaluators.