Resuscitation
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Randomized Controlled Trial Comparative Study
A manually powered mechanical resuscitation device used by a single rescuer: a randomised controlled manikin study.
The goal of this randomized, open, controlled crossover manikin study was to compare the performance of "Animax", a manually operated hand-powered mechanical resuscitation device (MRD) to standard single rescuer basic life support (BLS). ⋯ Single rescuer cardio-pulmonary resuscitation with the manually operated MRD was superior to standard BLS regarding chest compressions in this simulation study. The MRD delivered a higher minute-volume but did not achieve the recommended minimal volume. Further clinical studies are needed to test the MRD's safety and efficacy in patients.
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Randomized Controlled Trial Comparative Study
A randomised control trial comparing two techniques for locating chest compression hand position in adult Basic Life Support.
Chest compressions performed correctly have the potential to increase survival post cardiac arrest. The 2005 European Resuscitation Council (ERC) guidelines altered and simplified instructions for hand position placement to increase the number of chest compressions performed. This randomised controlled trial compares chest compression efficacy (hand position and number of effective chest compressions) after training using the 2005 guidelines or the 2005 guidelines with a hand position modification based on 2000 ERC guidelines. ⋯ The use of landmark measurement techniques in hand placement for external chest compressions does not have a detrimental effect on the number of chest compressions performed during BLS and increases correct hand positioning.
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Mild hypothermia treatment (32-34°C) in survivors after cardiac arrest (CA) is clearly recommended by the current guidelines. The effects of cooling procedure towards QT interval have not been evaluated so far outside of case series. In a prospective study 34 consecutive survivors after cardiac arrest were continuously monitored with Holter ECG over the first 48 h. ⋯ The QTc interval was found to be significantly prolonged during MTH treatment, and some severe prolongations >670 ms were observed, without a higher incidence of life-threatening arrhythmias, especially no Torsade des pointes were detected. However, routine and frequent ECG recording with respect to the QTc interval should become part of any hypothermia standard operation protocol and should be recommended by official guidelines.
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Comparative Study
Aeromedical transfer to reduce delay in primary angioplasty.
Aeromedical transfer can reduce transfer times for primary percutaneous coronary intervention (PPCI). Delays in dispatch of the helicopter and landing-reperfusion can reduce the benefits of air travel. The ad hoc nature of these transfers may compound delays. A formal aeromedical transfer service, with rapid dispatch protocols and rapid landing to balloon times could significantly reduce reperfusion times. ⋯ This SOP delivered sub 120 min call-balloon times in all cases undergoing PPCI from difficult locations where anticipated land journeys were >30 min. With longer anticipated land journeys (or more remote locations) the proportional gains with air transfer will be greater. Subject to a formal SOP and very rapid landing-balloon times, aeromedical transfer can significantly reduce the number of patients suffering long reperfusion delays in acute myocardial infarction.
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Comparative Study
Post-resuscitation care at the emergency department with critical care facilities--a length-of-stay analysis.
An emergency department providing critical care will have an effect on outcome and intensive-care-units' resources by avoiding unnecessary or futile intensive-care admissions and thereby save hospital expenses. The study focussed on this result. ⋯ An emergency department with critical care prevents admissions to intensive care units in 28% of patients with out-of-hospital cardiac arrest. It saves intensive-care-unit resources and shortens length of stay for comatose out-of-hospital cardiac-arrest survivors, regardless of their outcome.