Resuscitation
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There has been little investigation on the appropriateness of the hand position suggested by various guidelines in paediatric cardiopulmonary resuscitation (CPR). We aimed to identify anatomical structures underneath the chest compression landmarks and tried to find the proper hand position using computed tomography (CT) images for more effective paediatric CPR. ⋯ The hand position at the inter-nipple line might be too high and that at the lower third of the sternum might be too low as it can compress the liver. Further studies are needed to find the proper hand position for more effective chest compression during paediatric CPR.
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We showed previously that ivabradine (IVA), a selective inhibitor of the cardiac pacemaker I(f) current, achieved protection against ischaemia-induced ventricular fibrillation (VF) in pigs by increasing the VF threshold (VFT). This was correlated to the heart rate reduction (HRR), the limitation of monophasic action potential shortening and the reduction of the hypoxic area. This study investigated myocyte ultrastructure and regional myocardial blood flow (RMBF), potentially involved in these cardioprotective effects of IVA. ⋯ IVA exerts a cardioprotection from ischaemia-induced VF by increasing RMBF and preserving cardiomyocyte and mitochondrial ultrastructure, which opens new perspectives regarding potential targets that would be involved in the anti-ischaemic effects of IVA.
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Editorial Comment
Surgical skills training: does it improve clinical outcome?
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Multicenter Study
Cardiac arrest survival did not increase in the Resuscitation Outcomes Consortium after implementation of the 2005 AHA CPR and ECC guidelines.
We examined the effect of the 2005 American Heart Association guidelines on survival in the Resuscitation Outcomes Consortium (ROC) Cardiac Arrest Epistry. ⋯ This study found no significant change in survival rate over time in the early months after implementation. Further longitudinal study is needed to determine the full impact of the guidelines on survival and methods to translate knowledge quickly and effectively in EMS.