Resuscitation
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Comparative Study
Impact of transport to critical care medical centers on outcomes after out-of-hospital cardiac arrest.
Post-resuscitation care has emerged as an important predictor of survival from out-of-hospital cardiac arrest (OHCA). In Japan, selected hospitals are certified as Critical Care Medical Centers (CCMCs) based on their ability and expertise. ⋯ Survival after OHCA of presumed cardiac etiology transported to CCMCs was better than those transported to NCCHs. For OHCA patients without field ROSC, transport to a CCMC was an independent predictor for a good neurological outcome.
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We examined the relationship between time from collapse to arrival of emergency medical services (EMS) and survival to hospital discharge for out-of-hospital ventricular fibrillation cardiac arrests in order to determine meaningful interpretations of this association. ⋯ The results of our analyses show that survival from out-of-hospital cardiac arrest does not decline at a constant rate following collapse. Models that incorporate changes that reflect the physiological alterations that occur following cardiac arrests are a more accurate way to describe changes in survival rates over time than models that include only a continuous term for time.
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Randomized Controlled Trial Comparative Study
Rescuer fatigue and cardiopulmonary resuscitation positions: A randomized controlled crossover trial.
During cardiopulmonary resuscitation (CPR), it is recommended to alternate rescuers every 2 min when two or more rescuers are available, regardless of the rescuer's position. It is unclear, however, whether rescuer fatigue depends on the rescuer's position. ⋯ CPR is best performed in a kneeling position. In order to minimize rescuer fatigue, we recommend alternating rescuers every 2 min while kneeling or standing on a taboret, and every 1 min while standing on the floor.
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Randomized Controlled Trial Comparative Study
Rapid sequence airway vs rapid sequence intubation in a simulated trauma airway by flight crew.
Rapid sequence airway (RSA) utilizes rapid sequence intubation (RSI) pharmacology followed by the placement of an extraglottic airway without direct laryngoscopy. ⋯ In a simulated moderately difficult trauma airway managed by FC, RSA results in a significantly shorter time to secure the airway and less hypoxemia compared to RSI.
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Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases. ⋯ Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome.