Resuscitation
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Randomized Controlled Trial
New visual feedback device improves performance of chest compressions by professionals in simulated cardiac arrest.
Quality of external chest compression (ECC) is a key component of Basic Life Support. Different approaches to improve rescuers' performance have been evaluated, but few attempts have been made to invent simple devices to improve performance. This study evaluates a new visual feedback system for ECC for healthcare professionals. ⋯ The new visual feedback device significantly improved ECC performance (compression rate and depth) by healthcare professionals in simulated cardiac arrest. Most participants found the device easy to use.
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There is mismatch in age between those usually trained in CPR and those witnessing out-of-hospital cardiac arrest with mean age reported at 30 and 65 years old, respectively. Two tier mass CPR self-training with manikin-DVD sets using school children has been reported. We have studied high school students as first tier and encouraged them to train older people. ⋯ People trained at home with a manikin-DVD set and high school students as facilitators were able to perform CPR as recommended by ERC guidelines with a reasonable percentage aged 50 or older.
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Randomized Controlled Trial
Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback.
Automated verbal and visual feedback improves quality of resuscitation in out-of-hospital cardiac arrest and was proven to increase short-term survival. Quality of resuscitation may be hampered in more difficult situations like emergency transportation. Currently there is no evidence if feedback devices can improve resuscitation quality during different modes of transportation. ⋯ Real time automated feedback improves certain aspects of CPR quality in flying helicopters and moving ambulance vehicles. The effect of feedback guidance was most pronounced for chest compression rate.
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Identifying early changes in hemostatic clot function as a result of tissue injury and hypoperfusion may provide important information regarding the mechanisms of traumatic coagulopathy. A combat-relevant swine model was used to investigate the development of coagulopathy during trauma by monitoring hemostatic function during increasing severity of shock. ⋯ In this swine model of traumatic shock, fibrinogen was significantly reduced and an isolated reduction in clot strength (MA) was found with increasing OD. Fibrinogen consumption and altered platelet function may account for the earliest changes in hemostatic function during traumatic shock.
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Hypothermia treatment with cold intravenous infusion and ice packs after cardiac arrest has been described and used in clinical practice. We hypothesised that with this method a target temperature of 32-34 degrees C could be achieved and maintained during treatment and that rewarming could be controlled. ⋯ Intravenous cold saline infusion combined with ice packs is effective in inducing and maintaining therapeutic hypothermia, with good temperature control even during rewarming.