Resuscitation
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Randomized Controlled Trial Comparative Study
Pre-training evaluation and feedback improved skills retention of basic life support in medical students.
Pre-training evaluation and feedback have been shown to improve medical students' skills acquisition of basic life support (BLS) immediately following training. The impact of such training on BLS skills retention is unknown. This study was conducted to investigate effects of pre-training evaluation and feedback on BLS skills retention in medical students. ⋯ Pre-training evaluation and feedback improved skills retention in the EF group for 12 months after the initial training, compared with the control group.
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Randomized Controlled Trial
A 10-s rest improves chest compression quality during hands-only cardiopulmonary resuscitation: A prospective, randomized crossover study using a manikin model.
This study was designed to assess changes in cardiopulmonary resuscitation (CPR) quality and rescuer fatigue when rescuers are provided with a break during continuous chest compression CPR (CCC-CPR). ⋯ When rescuers were provided a rest at a particular time during CCC-CPR, chest compression quality increased compared with CCC without rest. Therefore, we propose that a rescuer should be provided a rest during CCC-CPR, and specifically, we recommend a 10-s rest after 100 chest compressions.
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This is the first clinical trial to evaluate whether successful endotracheal intubation (ETI) using a video-laryngoscope (VL) (GlideScope(®)) can be performed easily without chest compression interruptions during actual cardiopulmonary resuscitation (CPR) after brief VL training, regardless of the physicians' levels of experience with successful ETI in the past. ⋯ In a clinical setting, the use of a VL had a high success rate for the first ETI attempt with notably few chest compression interruptions, regardless of the physicians' varying experience with successful ETI in the past.
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The quality of cardiopulmonary resuscitation (CPR) is important to survival after cardiac arrest. Mechanical devices (MD) provide constant CPR, but their effectiveness may be affected by deployment timeliness. ⋯ Rescuers spent a significant amount of time on MD deployment, leading to long no-flow times. Lack of familiarity with the device and positioning strategy were associated with poor performance. Additional training in device deployment strategies are required to improve the benefits of mechanical CPR.
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When providing advanced life support (ALS) in cardiac arrest, the patient may alternate between four clinical states: ventricular fibrillation/tachycardia (VF/VT), pulseless electrical activity (PEA), asystole, and return of spontaneous circulation (ROSC). At the end of the resuscitation efforts, either death has been declared or sustained ROSC has been obtained. The aim of this study was to describe and analyze the clinical state transitions during ALS among patients experiencing in-hospital cardiac arrest. ⋯ We provide an overall picture of the intensities and patterns of clinical state transitions during in-hospital ALS. The majority of patients who obtained sustained ROSC obtained this state and stabilized within the first 15-20 min of ALS. Those who continued to behave unstably after this time point had a high risk of ultimately being declared dead.