Resuscitation
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Randomized Controlled Trial
Randomised study of hypertonic saline infusion during resuscitation from out-of-hospital cardiac arrest.
Animal models of hypertonic saline infusion during cardiopulmonary resuscitation (CPR) improve survival, as well as myocardial and cerebral perfusion during CPR. We studied the effect of hypertonic saline infusion during CPR (Guidelines 2000) on survival to hospital admission and hospital discharge, and neurological outcome on hospital discharge. ⋯ Hypertonic saline infusion during CPR using Guidelines 2000 did not improve survival to hospital admission or hospital discharge. There was a small improvement with hypertonic saline in the secondary endpoint of neurological outcome on discharge in survivors. Further adequately powered studies using current guidelines are needed.
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Comparative Study
Cardiopulmonary resuscitation for hospital inpatients in Taiwan: an 8-year nationwide survey.
Cardiopulmonary resuscitation (CPR) is widely used to treat cardiac arrest, but the success rate has remained unchanged for decades. This study evaluated CPR performance and success rate among hospital inpatients in Taiwan. ⋯ The significant reduction in CPR during hospitalization may reflect implementation of a national "Do Not Resuscitate" policy. Predictive factors of successful CPR among hospital inpatients and the determinants of appropriate withholding of CPR remain unclear.
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Comparative Study
Comparison of relative and actual chest compression depths during cardiac arrest in children, adolescents, and young adults.
Cardiopulmonary resuscitation (CPR) guidelines recommend specific chest compression (CC) target depths for children. We quantitatively describe relative anterior-posterior diameter (APD) depth, actual depth, and force of CCs during real CPR events in children. ⋯ During in-hospital cardiac arrest of children ≥8 years, CCs delivered by resuscitation teams were frequently <1/3 relative APD and <38 mm actual depth after mattress deflection correction, below pediatric and adult target guidelines. Mean CC actual depth and force were not significantly different in pre-puberty and post-puberty. Additional investigation to determine depth of CCs to optimize hemodynamics and outcomes is needed to inform future CPR guidelines.
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It is unclear whether advanced airway management during ambulance transport is associated with improved out-of-hospital cardiac arrest (OHCA) outcomes compared with bag-valve mask ventilation (BVM). This study aimed to determine whether EMT-intermediate ETI or LMA is associated with improved OHCA outcomes in Korea. ⋯ In Korea, EMT-I placed LMA during ambulance transport was associated with worsened OHCA survival to discharge than BVM. Outcomes were similar between EMT-I endotracheal intubation and bag-valve-mask ventilation.
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A simulation program was implemented in a pre-registration nursing curriculum for developing nursing students' performances in assessing, managing and reporting in relation to patients with physiological deterioration. ⋯ The findings provide an understanding of how a simulation program may impact on the nursing students' performances in clinical practice, which is useful information for future improvement of programmes to optimize learning and transfer effective care to patient care settings.