Resuscitation
-
Previous studies of paediatric cardiac arrest have reported a low survival rate but there is limited data from Australia. We sought to determine the characteristics and outcomes of paediatric out-of-hospital cardiac arrest in Melbourne, Australia. ⋯ Overall, 7.7% of paediatric patients with out-of-hospital cardiac arrest survive to leave hospital. Increased survival was seen if the initial cardiac rhythm was ventricular fibrillation. Survival was very rare (<1%) unless there was return of spontaneous circulation prior to hospital arrival.
-
Cardiogenic shock is the main cause of death in patients hospitalized due to an acute myocardial infarction. Mild hypothermia reduces metabolism and could offer protective effects for this condition. The aim of our study was to investigate if mild therapeutic hypothermia would improve outcome and hemodynamic parameters in an ischemic cardiogenic shock pig model. ⋯ In this pig model, mild therapeutic hypothermia reduces acute mortality in cardiogenic shock, improves hemodynamic parameters and reduces metabolic acidosis. These findings suggest a possible clinical benefit of therapeutic hypothermia for patients with acute cardiogenic shock.
-
Comparative Study
Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compressions: a manikin study.
If tracheal intubation can be performed during uninterrupted chest compressions, this will sustain circulation during the procedure of intubation and may lead to successful resuscitation. We compared three types of laryngoscope on a manikin as to whether they enabled tracheal intubation while the manikin's chest was rhythmically compressed. ⋯ These results suggest that the use of the Pentax-AWS enables tracheal intubation while the patient's chest is rhythmically compressed, and would more often lead to successful intubation, which in turn may lead to more successful resuscitation.
-
The 'chain of survival' has been a useful tool for improving the understanding of, and the quality of the response to, cardiac arrest for many years. In the 2005 European Resuscitation Council Guidelines the importance of recognising critical illness and preventing cardiac arrest was highlighted by their inclusion as the first link in a new four-ring 'chain of survival'. However, recognising critical illness and preventing cardiac arrest are complex tasks, each requiring the presence of several essential steps to ensure clinical success. ⋯ The five rings of the chain represent 'staff education', 'monitoring', 'recognition', the 'call for help' and the 'response'. It is believed that a 'chain of prevention' has the potential to be understood well by hospital clinical staff of all grades, disciplines and specialties, patients, and their families and friends. The chain provides a structure for research to identify the importance of each of the various components of rapid response systems.