Resuscitation
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The purpose of this study was to investigate whether the takeover by Advanced Life Support [ALS] trained ambulance paramedics from rescuers using an automated external defibrillator [AED] delays shocks and if this delay is associated with decreased survival after out-of-hospital cardiac arrest [OHCA]. ⋯ ALS takeover delays the next shock delivery in almost two-third of cases. This delay is associated with decreased survival.
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Comparative Study
Increase in pre-shock pause caused by drug administration before defibrillation: an observational, full-scale simulation study.
The importance of circulation during cardiopulmonary resuscitation has led to efforts to decrease time without chest compressions ("no-flow time"). The no-flow time from the interruption of chest compressions until defibrillation is referred to as the "pre-shock pause". A shorter pre-shock pause increases the chance of successful defibrillation. It is unclear whether drug administration affects the length of the pre-shock pause. Our study compares pre-shock pause with and without drug administration in a full-scale simulation. ⋯ Drug administration prior to defibrillation was associated with significant increases in pre-shock pauses in this full-scale simulation study.
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To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning. ⋯ Predictive pre-resuscitation factors may supplement patient-specific information available at bedside to assist in revising resuscitation plans during the patient's hospitalization.
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This observational study aims to describe: (1) the use of positive pressure ventilation (PPV) for resuscitation in the delivery room among newly born near-term infants; (2) the methods used for PPV resuscitation [e.g., bag-facial mask (BFM), laryngeal mask airway (LMA), endotracheal tube (ETT)]; and (3) the association of each device with short-term neonatal outcomes. ⋯ The LMA is an effective device for primary airway management of near-term infants and for secondary airway management among near-term infants failing BFM or ETT resuscitation.
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Biography Historical Article
Dominique-Jean Larrey: the effects of therapeutic hypothermia and the first ambulance.
The fields of emergency medicine and resuscitation are indebted to the Baron Dominique-Jean Larrey (1766-1842) for significant advances in patient care. Larrey was a great surgeon who served in the French army during Napoleon's rule. ⋯ Larrey coined the term "Triage" to allocate resources to those most in need of emergent care. Today, many of his techniques still prevail in modern medicine.