Resuscitation
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The post-cardiac arrest syndrome (period of critical illness following return of spontaneous circulation [ROSC]) is a promising window of opportunity for clinical trials of therapeutic interventions to improve outcome from cardiac arrest. However, the methodological rigor of post-ROSC trials and the ability to compare or pool data on treatment effects across studies requires consistent and appropriate outcome measures. We aimed to determine the current degree of uniformity of outcome measures in clinical trials of post-ROSC interventions. ⋯ Currently there is a lack of uniformity in selection and reporting of outcome measures among trials of post-ROSC interventions. Achieving consensus would be an important advance for resuscitation science.
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The optimal depth of sternal compressions during cardiopulmonary resuscitation (CPR) in infants is unknown; current guidelines recommend compressing to a depth of 1/3rd to 1/2 the anterior-posterior (AP) diameter of the chest. Our experience to compress the chest at 1/3rd the AP diameter often fails to provide an adequate blood pressure response. We reviewed our experience with CPR, depth of compressions, and arterial blood pressure response in a cohort of 6 infants having cardiac surgery and subsequent cardiac arrest. ⋯ The mean diastolic pressure was similar with both strategies (30.5 vs. 30.6mm Hg, p=0.99). In this cohort of 6 infants having cardiac surgery and subsequent cardiac arrest, attempting to compress the chest at 1/2 the AP diameter increased systolic blood pressure by 62% compared to attempting to compress 1/3rd the AP diameter. Perhaps resuscitators should attempt to compress infants' chests 1/2 rather than 1/3rd the AP diameter of the chest.
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Randomized Controlled Trial Comparative Study
Animation-assisted CPRII program as a reminder tool in achieving effective one-person-CPR performance.
The objective of this study is to compare the skill retention of two groups of lay persons, six months after their last CPR training. The intervention group was provided with animation-assisted CPRII (AA-CPRII) instruction on their cellular phones, and the control group had nothing but what they learned from their previous training. ⋯ The AA-CPRII group resulted in better checklist scores, including chest compression rate, depth and hand positioning. Animation-assisted CPR could be used as a reminder tool in achieving effective one-person-CPR performance. By installing the CPR instruction on cellular phones and having taught them CPR with it during the training enabled participants to perform better CPR.