Resuscitation
-
Randomized Controlled Trial Comparative Study
Comparison of two mechanical intraosseous infusion devices: a pilot, randomized crossover trial.
Administration of medications via the intraosseous (IO) route has proven to be a lifesaving procedure in critically ill or injured children. Two mechanical IO infusion devices have been approved for use in children, the spring-loaded IO infusion device (Bone Injection Gun, BIG) and the battery-powered IO infusion drill (EZ-IO). The objective of this pilot study was to compare the success rates for insertion and the ease-of-use of the two devices. ⋯ As tested by paramedic students on a turkey bone model, the EZ-IO demonstrated higher success rates than the BIG and was the preferred device. Future studies are planned to determine which of the two devices is more appropriate for obtaining IO access in the setting of paediatric emergencies.
-
Comparative Study
Tuition of emergency medical dispatchers in the recognition of agonal respiration increases the use of telephone assisted CPR.
Bystanders cardiopulmonary resuscitation (CPR) increases survival in out-of-hospital cardiac arrest (OHCA). Emergency medical dispatchers (EMDs) can provide even totally inexperienced bystanders with instructions by telephone on how to resuscitate victims (T-CPR) until the emergency medical services (EMS) arrive. Agonal respiration makes it difficult for EMDs to identify cardiac arrests (CAs) which will prevent or delay initiation of T-CPR. The aim of this investigation was to study if tuition of EMDs can improve their ability to identify agonal respiration in OHCA to allow for more frequent offers of T-CPR. ⋯ Teaching EMDs to understand and recognize bystander descriptions of agonal respiration in patients with OHCA has resulted in a significant increase in offers of T-CPR in these situations.
-
Comparative Study Clinical Trial
Is a 4 days transoesophageal training course sufficient to diagnose shock related pathologies?
Echocardiography is a useful tool in patients suffering from shock of unknown origin to evaluate cardiac function and volume status in order to decide on further treatment. The aim of the study was to evaluate how well participants could identify function, preload and regional wall motion abnormalities after attending a 4-day transoesophageal echocardiography (TOE) seminar. ⋯ The results of the investigation show that participants of a 4-day TOE seminar can interpret left ventricular function, preload and regional wall motion abnormalities correctly at a very high rate. TOE seminars seem to be effective in teaching basic theoretical knowledge of TOE.
-
Multicenter Study Comparative Study
Nationwide survey of resuscitation education in Finland.
Good-quality cardiopulmonary resuscitation (CPR) is highlighted in the International Resuscitation Guidelines, but clinically the quality of CPR is often poor. Education of CPR has a major role in the primary skills imparted to students. Different methods can be used to teach CPR quality. We evaluated the current status of their usage in Finland institutes teaching students of emergency medicine at different levels. ⋯ The hours of theoretic lessons and small group training vary widely among different institutes. In one-third of institutions, the instructor's visual estimation was a sole method used to teach adequate chest compression rate and depth. Different technical methods were surprisingly seldom used.
-
Comparative Study
Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: a prospective computed tomography study.
Aneurysmal subarachnoid haemorrhage (SAH) is a relatively common cause of out-of-hospital cardiac arrest (OHCA). Early identification of SAH-induced OHCA with the use of brain computed tomography (CT) scan obtained immediately after resuscitation may help emergency physicians make therapeutic decision as quickly as they can. ⋯ Aneurysmal SAH causes OHCA more frequently than had been believed. Immediate brain CT scan may particularly be useful in excluding SAH-induced OHCA from thrombolytic trial enrollment, for whom the use of thrombolytics is contraindicated. The low VF incidence suggests that VF by itself may not be a common cause of SAH-induced OHCA.