Resuscitation
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Review
The use of CPR feedback/prompt devices during training and CPR performance: A systematic review.
In lay persons and health care providers performing cardiopulmonary resuscitation (CPR), does the use of CPR feedback/prompt devices when compared to no device improve CPR skill acquisition, retention, and real life performance? ⋯ There is good evidence supporting the use of CPR feedback/prompt devices during CPR training to improve CPR skill acquisition and retention. Their use in clinical practice as part of an overall strategy to improve the quality of CPR may be beneficial. The accuracy of devices to measure compression depth should be calibrated to take account of the stiffness of the support surface upon which CPR is being performed (e.g. floor/mattress). Further studies are needed to determine if these devices improve patient outcomes.
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To assess the prognostic value of repetitive serum samples of neuron specific enolase (NSE) and S-100B in cardiac arrest patients treated with hypothermia. ⋯ NSE was a better marker than S-100B for predicting outcome after cardiac arrest and induced hypothermia. NSE above 28microg/l at 48h and a rise in NSE of more than 2microg/l between 24 and 48h were markers for a poor outcome.
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Randomized Controlled Trial
Reduced effectiveness of vasopressin in repeated doses for patients undergoing prolonged cardiopulmonary resuscitation.
The efficacy of repeated administration of vasopressin alone during prolonged cardiopulmonary resuscitation (CPR) remains unconfirmed. This study was conducted to estimate the effectiveness of the repeated administration of vasopressin vs. epinephrine for cardiopulmonary arrest (CPA) patients receiving prolonged CPR. ⋯ This is the first report of a possible vasopressin-alone resuscitation without additional epinephrine. However, repeated injections of either vasopressin or epinephrine during prolonged advanced cardiac life support resulted in comparable survival.
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This study was done to determine the effect of ambient temperature on cold saline during simulated infusion to induce therapeutic hypothermia. The study hypothesis was that cold saline would warm rapidly during simulated infusion and that an insulating SIGG neoprene pouch would slow the process. ⋯ During simulated infusion to induce therapeutic hypothermia, cold saline begins to warm toward ambient temperature but the rate is not rapid. An insulating SIGG neoprene pouch slows the rate of warming.
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Case Reports
Laryngeal tube suction II for difficult airway management in neonates and small infants.
Difficult paediatric airways, both expected and unexpected, present major challenges to every anaesthesiologist, paediatrician and emergency physician. However, the integration of supraglottic airway devices, such as the laryngeal mask (LM), into the algorithm of difficult airways has improved the handling of difficult airway situations in patients. A recent device for establishing a supraglottic airway is the laryngeal tube, introduced in 1999. We report on the successful use of the laryngeal tube suction II (LTS II) in securing the airway when endotracheal intubation or alternative mask ventilation has failed. ⋯ The potential advantage of the LTS II is the suction port which allows gastric tube placement and subsequent egression of gastric contents. In emergency situations when direct laryngoscopy fails, or is too time-consuming because of anatomical abnormalities, we recommend the LTS II tube as the first-line device to secure the airway. As with all supraglottic airways, familiarity and clinical experience with the respective device and its insertion technique is essential for safe and successful use, especially in emergencies.