Resuscitation
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To describe cognitive functioning with neuropsychological tests and examine predictors of cognitive outcome in adult survivors of out-of-hospital cardiac arrest (OHCA) of cardiac cause. ⋯ Cognitive outcome was normal in more than half of the survivors. Shorter coma duration and induced hypothermia were associated with favourable cognitive outcomes in the participating survivors three months after OHCA. Institutional protocol number: 2009/1395.
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Review Comparative Study
Systematic review of the mechanisms driving effective blood flow during adult CPR.
High quality chest compressions is the most significant factor related to improved short-term and long-term outcome in cardiac arrest. However, considerable controversy exists over the mechanisms involved in driving blood flow. ⋯ The evidence so far is inconclusive regarding the major responsible mechanism in compression-related blood flow. Although both 'cardiac pump' and 'thoracic pump' have a key role, the effect of each mechanism is highly depended on other resuscitation parameters, such as positive pressure ventilation and compression depth.
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To explore the concept of debriefing bystanders after participating in an out-of-hospital cardiac arrest resuscitation attempt including (1) bystanders' most commonly addressed reactions after participating in a resuscitation attempt when receiving debriefing from medical dispatchers; (2) their perception of effects of receiving debriefing and (3) bystanders' recommendations for a systematic debriefing concept. ⋯ Debriefing by emergency medical dispatchers to OHCA bystanders stimulates reflection, positively influencing the ability to cope with the emotional reactions and the cognitive perception of own performance and motivates improvement of CPR skills. Importantly, it increases confidence to provide CPR in the future. Implementation of telephone debriefing to bystanders at Emergency Medical Dispatch Centres is a low complexity and a low cost intervention though the logistic challenges have to be considered.
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The treatment for a cardiac arrest, cardiopulmonary resuscitation (CPR), may be lifesaving following an acute, potentially reversible illness. Yet this treatment is unlikely to be effective if cardiac arrest occurs as part of the dying process towards the end of a person's natural life. Do not attempt CPR (DNACPR) decisions allow resuscitation to be withheld when it has little chance of success, or where the patient, or those close to the patient, indicate the burdens of CPR outweigh the benefits. This review sought to identify evidence for systems that improve the appropriate use of DNACPR decisions. ⋯ Relatively simple process changes may enhance the appropriate use of and outcomes associated with DNACPR decisions. Systematic review registration number: PROSPERO2012:CRD42012002669.