Resuscitation
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Recent adult reports have demonstrated sub-optimal performance of basic cardiopulmonary resuscitation (CPR) skills in advanced training scenarios and real life arrest situations. We studied the adequacy of chest compressions performed by advanced trained pediatric providers in code scenarios. ⋯ Advanced training of pediatric providers does not ensure adequate delivery of chest compressions. Rate standards and adequate depth of chest compressions are infrequently achieved and both may need more emphasis in CPR training and attention during resuscitations.
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Multicenter Study Controlled Clinical Trial
A prospective controlled trial of the effect of a multi-faceted intervention on early recognition and intervention in deteriorating hospital patients.
To determine whether the introduction of a multi-faceted intervention (newly designed ward observation chart, a track and trigger system and an associated education program, COMPASS) to detect clinical deterioration in patients would decrease the rate of predefined adverse outcomes. ⋯ The introduction of a multi-faceted intervention to detect clinical deterioration may benefit patients through increased monitoring of vital signs and the triggering of a medical review following an episode of clinical instability.
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Avalanche resuscitation will save lives if focussed on victims that have the potential to survive. The purpose of this systematic review was to examine 4 critical prognostic factors for burial victims in cardiac arrest. ⋯ After 35 min of burial, or where the core temperature is less than 32 degrees C, a patent airway is associated with survival to hospital discharge. A serum potassium of less than 7 mmol/L may be a valuable indicator for survival when other indicators are unclear. These findings should modify the current avalanche resuscitation scheme.