Resuscitation
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Cardiac arrest is a common presentation to the emergency care system. The decision to terminate CPR is often challenging to heath care providers. An accurate, early predictor of the outcome of resuscitation is needed. The purpose of this systematic review is to evaluate the prognostic value of ETCO2 during cardiac arrest and to explore whether ETCO2 values could be utilised as a tool to predict the outcome of resuscitation. ⋯ ETCO2 values during CPR do correlate with the likelihood of ROSC and survival and therefore have prognostic value. Although certain ETCO2 cut-off values appears to be a strong predictor of mortality, the utility of ETCO2 cut-off values during CPR to accurately predict the outcome of resuscitation is not fully established. Therefore, ETCO2 values cannot be used as a mortality predictor in isolation.
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Children have better outcomes after out-of-hospital cardiac arrest (OHCA) than adults. However, little is known about the difference in outcomes between children and adults after OHCA due to drowning. ⋯ In this large OHCA registry, children had better one-month survival rates after OHCA due to drowning compared with adults. Most survivors in all groups had unfavorable neurological outcomes.
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To build new algorithms for prognostication of comatose cardiac arrest patients using clinical examination, and investigate whether therapeutic hypothermia influences the value of the clinical examination. ⋯ The clinical examination remains central to prognostication in comatose cardiac arrest patients in the modern area. Future studies should incorporate the clinical examination along with modern technology for accurate prognostication.
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Randomized Controlled Trial
The design of instructional tools affects secondary school students' learning of Cardiopulmonary Resuscitation (CPR) in reciprocal peer learning: A randomized controlled trial.
Research investigating design effects of instructional tools for learning Basic Life Support (BLS) is almost non-existent. ⋯ This study shows that the design of instructional tools (i.e., task cards) affects student learning. Research-based design of learning tools can enhance BLS and CPR education.
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Quality chest compressions (CC) are the most important factor in successful cardiopulmonary resuscitation. Adjustment of CC based upon an invasive arterial blood pressure (ABP) display would be theoretically beneficial. Additionally, having one compressor present for longer than a 2-min cycle with an ABP display may allow for a learning process to further maximize CC. Accordingly, we tested the hypothesis that CC can be improved with a real-time display of invasively measured blood pressure and with an unchanged, physically fit compressor. ⋯ Our study confirms the hypothesis that a real-time display of simulated ABP during CPR that responds to participant performance improves achieved and sustained ABP. However, without any real-time visual feedback, even fit compressors demonstrated degradation of CC quality.