Resuscitation
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Randomized Controlled Trial Comparative Study
A prospective evaluation of the efficacy of the laryngeal mask airway during neonatal resuscitation.
To study the feasibility, efficacy and safety of using the laryngeal mask airway (LMA) in neonatal resuscitation. ⋯ The LMA is safe, effective and easy to implement for the resuscitation of neonates with a gestational age of 34 or, more weeks.
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Randomized Controlled Trial Comparative Study
Comparison of traditional versus high-fidelity simulation in the retention of ACLS knowledge.
We performed a single-blinded, randomized controlled trial to evaluate the retention of advanced cardiac life support (ACLS) knowledge between high-fidelity simulation training (HFST) and traditional training (TT) in medical students. ⋯ Students demonstrated greater ACLS knowledge initially with HFST than with TT. However, after 1-year, both groups performed the same. Satisfaction with training was higher with HFST compared to TT. Confidence in ACLS knowledge was the same initially and decreased similarly over a 1-year time period regardless of the type of ACLS training. Further studies will need to determine optimal strategies to retain ACLS knowledge.
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Editorial Comment
Do smartphones help deliver high-quality resuscitation care?
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Studies investigating the quality of cardiopulmonary resuscitation (CPR) have revealed frequent unnecessary interruptions of life support. The primary objective of the study is to analyze what happens during interruptions. We investigated (a) whether interruptions are filled with "secondary activities", i.e., activities only indirectly related to the primary task of providing life support (e.g., preparatory and diagnostic activities), and (b) whether all group members focus on the same secondary activity during interruptions, thus impeding group coordination, and detracting from the primary task of providing life support. ⋯ Unnecessary interruptions of CPR occur frequently and consume approximately one-third of the time patients should receive continuous life support. Unnecessary interruptions are mainly characterized by secondary medical activities that may be perceived as meaningful. During the majority of unnecessary interruptions, all team members focus on the same secondary activity, indicating shortcomings in task distribution in the resuscitation team. The findings emphasize the importance of team training with particular emphasis on situational awareness and task distribution.
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In the prehospital setting opioid overdose is often treated with naloxone. In our physician-based medical emergency care unit (MECU) we have adopted a discharge-on-scene policy, where patients are released on scene if no residual signs of opioid intoxication are found after treatment. The aim of this study was to describe our experience with the discharge-on-scene policy used during a 10-year-period with focus on the frequency of rebound opioid toxicity. ⋯ Prehospital discharge-on-scene after naloxone treatment is associated with a low risk of death due to rebound toxicity.