Resuscitation
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Randomized Controlled Trial Comparative Study
Quality of chest compressions during continuous CPR; comparison between chest compression-only CPR and conventional CPR.
This study aimed to compare the time-dependent deterioration of chest compressions between chest compression-only cardiopulmonary resuscitation (CPR) and conventional CPR. ⋯ Chest compressions with appropriate depth decreased more rapidly during chest compression-only CPR than conventional CPR. We recommend that CPR providers change their roles every 1 min to maintain the quality of chest compressions during chest compression-only CPR. (UMIN-CTR C0000000321).
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To develop a new method to suppress the artefact generated by chest compressions during cardiopulmonary resuscitation (CPR) using only the frequency of the compressions as additional information. ⋯ For a similar sensitivity, we obtained better specificity than that reported for other methods, although still short of the values recommended by the American Heart Association. The results suggest that the CPR artefact can be accurately modelled using only the frequency of the compressions. This information could be easily acquired through the defibrillator's CPR help pads, with minimal hardware modifications.
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Review
Scientific, legal, and ethical challenges of end-of-life organ procurement in emergency medicine.
We review (1) scientific evidence questioning the validity of declaring death and procuring organs in heart-beating (i.e., neurological standard of death) and non-heart-beating (i.e., circulatory-respiratory standard of death) donation; (2) consequences of collaborative programs realigning hospital policies to maximize access of procurement coordinators to critically and terminally ill patients as potential donors on arrival in emergency departments; and (3) ethical and legal ramifications of current practices of organ procurement on patients and their families. ⋯ Policies enforcing end-of-life organ procurement can have unintended consequences: (1) erosion of care in the patient's best interests, (2) lack of transparency, and (3) ethical and legal ramifications of flawed standards of declaring death.
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Comparative Study
An evaluation of bag-valve-mask ventilation using an ergonomically designed facemask among novice users: a simulation-based pilot study.
We sought to compare the ability of novice operators to provide artificial ventilation using a standard facemask and a new ergonomically designed facemask. Whether or not proper technique was used was also assessed. ⋯ Novice airway operators were better able to provide facemask ventilation using an ergonomically designed mask than with a traditional facemask. We conclude that better hand position facilitating improved mask seal and less operator fatigue account for our findings.