Resuscitation
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Observational Study
Evaluation of pre-arrest morbidity score and prognosis after resuscitation score and other clinical variables associated with in-hospital cardiac arrest in southern Sweden.
To evaluate pre-arrest morbidity score (PAM), prognosis after resuscitation score (PAR) and to identify additional clinical variables associated with survival after in-hospital cardiac arrest (IHCA) treated with cardiopulmonary resuscitation (CPR). ⋯ PAM- and PAR-scores do not sufficiently discriminate between in-hospital death and survival after IHCA to be used as clinical tools guiding CPR decisions. We confirm that malignancy is associated with increased in-hospital mortality, and cardiac monitoring, shockable rhythm, STEMI and independent ADL, with decreased in-hospital mortality. Interestingly, our results suggest that HR and plasma sodium concentration upon admission may represent new tools for risk stratification.
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The use of hands-on defibrillation (HOD) to reduce interruption of chest compression after cardiac arrest has been suggested as a means of improving resuscitation outcomes. The potential dangers of this strategy in regard to exposing rescuers to electrical energy are still being debated. This study seeks to determine the plausible worst-case energy-transfer scenario that rescuers might encounter while performing routine resuscitative measures. ⋯ HOD using currently available personal protective equipment and resuscitative procedures poses a risk to rescuers. The process should be considered potentially dangerous until equipment and techniques that will protect rescuers are developed.
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Comparative Study
Average current is better than peak current as therapeutic dosage for biphasic waveforms in a ventricular fibrillation pig model of cardiac arrest.
Defibrillation current has been shown to be a clinically more relevant dosing unit than energy. However, the effects of average and peak current in determining shock outcome are still undetermined. The aim of this study was to investigate the relationship between average current, peak current and defibrillation success when different biphasic waveforms were employed. ⋯ In this porcine model of VF, average current was better than peak current to be an adequate parameter to describe the therapeutic dosage when biphasic defibrillation waveforms were used. The institutional protocol number: P0805.
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Observational Study
The availability, condition and employability of automated external defibrillators in large city centres in the Netherlands.
In the Netherlands there are, at the time of writing, no clear guidelines about the implementation of automated external defibrillators (AEDs). An observational study was conducted to investigate the current status of AEDs in city centres in the Netherlands looking specifically at the availability, condition and employability of the AEDs. ⋯ Our study demonstrates that although national guidelines have not been implemented, a reasonable amount of AEDs can be found. However there is certainly room for improvement in the current availability, condition and employability of AEDs in city centres in the Netherlands.