Resuscitation
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Emergency medical services (EMS) in Hong Kong, now a Special Administrative Region of the People's Republic of China, have a distinguished history spanning more than 50 years. This paper outlines the history and the development of the Hong Kong EMS, with a particular focus on the ambulance service, the design of the system and the training of its staff.
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Multicenter Study
Australasian resuscitation of sepsis evaluation (ARISE): A multi-centre, prospective, inception cohort study.
Determine current resuscitation practices and outcomes in patients presenting to the emergency department (ED) with sepsis and hypoperfusion or septic shock in Australia and New Zealand (ANZ). ⋯ Management of ANZ patients presenting to ED with sepsis does not routinely include protocolised, ScvO(2)-directed resuscitation. In-hospital mortality compares favourably with reported mortality in international sepsis trials and nationwide surveys of resuscitation practices.
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Drowning is a unique form of cardiac arrest and is often preventable. "Utstein Style for Drowning" was published in 2003 by the International Liaison Committee on Resuscitation (ILCOR) to improve the knowledge-base, to provide epidemiological stratification, to recommend appropriate treatments and to ultimately save lives. We report on the largest single-center study of the Utstein Style resuscitation for drowning. ⋯ Our report is the largest single-center study of OHCA due to drowning reported according to the guidelines of the Utstein Style. Being witnessed, having a short duration of submersion, having early resuscitation by EMS, and rapid transportation are important for survival after drowning.
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To determine if a new protocol can increase the detection of agonal respirations by emergency medical dispatchers and thus the presence of cardiac arrest. ⋯ Introduction of a new 9-1-1 dispatcher assessment protocol to assess for the presence of agonal respirations can significantly increase the detection cardiac arrest over the telephone.
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There is mounting evidence to support the concept of chest compression-only CPR for out-of-hospital cardiac arrest victims, not least because it is simple and does not require rescuers to perform unpleasant mouth-to-mouth ventilation. The problem is that for a small, but important, minority of victims (children and those suffering an asphyxial or prolonged arrest) this is suboptimal treatment. The forthcoming guidelines revision process will require a compromise to be reached. The solution proposed is citizen training in two stages: adult compression-only CPR initially, then a second, follow-up stage when ventilation is added to satisfy the needs of minority victims.