Resuscitation
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Randomized Controlled Trial Comparative Study
A randomised, simulated study assessing auscultation of heart rate at birth.
Heart rate is a primary clinical indicator directing newborn resuscitation. The time taken to assess the heart rate by auscultation in relation to accuracy during newborn resuscitation is not known. ⋯ Mean time to estimate heart rate for the scenarios varied between 7.8 and 17.0s. Twenty-eight percent of all heart rate assessments would have prompted incorrect management during resuscitation or stabilization. Of incorrect assessments, 73% were overestimations. Further research is required to develop a rapid and accurate method for determining heart rate during newborn resuscitation.
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Comparative Study
Influence of an impedance threshold valve on ventilation with supraglottic airway devices during cardiopulmonary resuscitation in a manikin.
This study investigates if a n impedance threshold valve (ITV) might improve survival after cardiac arrest by increasing vital organ blood flow. The combination of ITV and supraglottic airway devices (SADs) has not been previously studied. This simulation study in a manikin aimed at analysing differences in ventilation with different SADs without and with an ITV. ⋯ Based on the findings of this manikin trial, the use of an ITV for ventilation during CPR is possible in combination with supraglottic airway devices. Merging these two strategies warrants further clinical evaluation to judge the relevance of tidal volume reduction found in this trial.
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Comparative Study
Incidence and outcomes of out-of-hospital cardiac arrest with shock-resistant ventricular fibrillation: Data from a large population-based cohort.
The increasing survival rates after out-of-hospital cardiac arrests (OHCA) are due mainly to improvements in the first 3 steps of the chain of survival. The aim of this study was to describe the temporal trends of OHCA incidence and outcomes with shock-resistant ventricular fibrillation (VF) requiring advanced life support procedures. ⋯ The actual incidence of shock-resistant VF has remained unchanged, and their outcomes continue to be dismal. Further efforts are required to reduce the mortality rates of such shock-resistant VF to achieve improved survival after OHCA.
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Comparative Study
Effect of cardiopulmonary resuscitation on intubation using a Macintosh laryngoscope, the AirWay Scope, and the gum elastic bougie: A manikin study.
Physicians could encounter difficult intubation during cardiopulmonary resuscitation (CPR) in trauma patients due to the patient's movement from continuous chest compression and to cervical stabilisation. Therefore, first, we evaluated the impact of chest compression with or without cervical stabilisation on intubation with a Macintosh laryngoscope. Next, we compared difficulty in intubation among the Macintosh laryngoscope, AirWay Scope (AWS), and gum elastic bougie (GEB) with the Macintosh laryngoscope in three simulated CPR scenarios in a randomised, controlled, cross-over study design. ⋯ CPR employing continuous chest compression with or without cervical stabilisation caused difficult intubation with the Macintosh laryngoscope. The AWS and GEB facilitated the easiest and second-easiest intubation, respectively, even during CPR employing continuous chest compression with or without cervical stabilisation in a manikin.