Resuscitation
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Comparative Study
Resuscitation feedback and targeted education improves quality of pre-hospital resuscitation in Scotland.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality and serious neurological morbidity in Europe. Recent studies have demonstrated the adverse physiological consequences of poor resuscitation technique and have shown that quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome from OHCA. Telemetry of the defibrillator transthoracic impedance (TTI) trace can objectively measure quality of pre-hospital resuscitation. This study aims to analyse the impact of targeted resuscitation feedback and training on quality of pre-hospital resuscitation. ⋯ Telemetry and analysis of the TTI trace following OHCA allows objective evaluation of the quality of pre-hospital resuscitation. Targeted resuscitation training and ambulance feedback improves the quality of pre-hospital resuscitation. Further studies are required to establish possible survival benefit from this technique.
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Comparative Study
Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation.
We compared the pharmacokinetics of intraosseous (IO) drug delivery via tibia or sternum, with central venous (CV) drug delivery during cardiopulmonary resuscitation (CPR). ⋯ IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose.
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Comparative Study
What is the relationship between the Glasgow coma scale and airway protective reflexes in the Chinese population?
To describe the relationship of gag and cough reflexes to Glasgow coma score (GCS) in Chinese adults requiring critical care. ⋯ Our study has shown that in a Chinese population with a wide range of critical illness (but little trauma or intoxication), reduced GCS is significantly related to gag and cough reflexes. However, a considerable proportion of patients with a GCS≤8 have intact airway reflexes and may be capable of maintaining their own airway, whilst many patients with a GCS>8 have impaired airway reflexes and may be at risk of aspiration. This has important implications for airway management decisions.
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Comparative Study
Pulmonary arterial thermodilution, femoral arterial thermodilution and bioreactance cardiac output monitoring in a pediatric hemorrhagic hypovolemic shock model.
Bioreactance is a new non-invasive method for cardiac output measurement (NICOM). There are no studies that have analysed the utility of this technique in a pediatric animal model of hemorrhagic shock. ⋯ PATD and FATD measurements showed similar responses to hypovolemic shock and volume expansion. Bioreactance persistently underestimates the CI and is not significantly altered by either inducing hemorrhagic shock, or later, through volume expansion. Bioreactance is not a suitable method for monitoring the CI in pediatric hemorrhagic shock.
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Comparative Study
The Supreme Laryngeal Mask Airway™ (LMA): a new neonatal supraglottic device: comparison with Classic and ProSeal LMA in a manikin.
The study aims to compare the performances (ease of insertion, time to establish effective ventilation and maximal inflation pressure) of classic™ (cLMA), ProSeal™ (PLMA) and Supreme™ (SLMA) Laryngeal Mask Airway when used in a neonatal airway management manikin by inexperienced delivery room trainees. The quality of the three devices, as perceived by participants, was also evaluated. ⋯ Neonatal SLMA is superior to PLMA in terms of time to establish effective ventilation; furthermore, maximal inflation pressure and quality perceived by the operator are higher with neonatal SLMA than with cLMA and PLMA. These manikin data could provide a useful guide for planning potential future clinical research involving the newly developed supraglottic device in neonates.