Resuscitation
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Cardiopulmonary resuscitation is one of the most vital therapeutic options for patients with cardiac arrest. Sufficient chest compression depth turned out to be of utmost importance to increase the likelihood of a return of spontaneous circulation. Furthermore, the use of real-time feedback-systems for resuscitation is associated with improvement of compression quality. The European Resuscitation Council changed their recommendation about minimal compression depth from 2005 (40 mm) to 2010 (50 mm). The aim of the present study was to determine whether this recommendation of the new guidelines was implemented successfully in an emergency medical service using a real-time feedback-system and to what extend a guideline-based CPR training leads to a "change in behaviour" of rescuers, respectively. ⋯ The present study was able to show a significant increase in chest compression depth after implementation of the new ERC guidelines. Even by using a real-time feedback system we failed to sustain chest compression quality at the new level as set by ERC Guidelines 2010. In consequence, the usefulness of a fixed chest compression depth should be content of further investigations.
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It is not known how often, to what extent and over what time frame any early warning scores change, and what the implications of these changes are. ⋯ AbEWS, without clinical judgment, cannot be used to detect those patients who do not need to be admitted to hospital or are suitable for discharge. A period of observation of at least 12h is required before the trajectory of AbEWS is of prognostic value, and any "improvement" that occurs before this time may be illusory.
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Observational Study
Duplex Sonography of Cerebral Blood Flow after Cardiac Arrest-A Prospective Observational Study.
Despite successful resuscitation, cardiac arrest (CA) often has a poor clinical prognosis. Different diagnostic tools have been established to predict patients' outcome. However, their sensitivity remains low. Assessment of cerebral perfusion by duplex ultrasound might provide additional information regarding the extent of neuronal damage. The aim of the present study was to analyse the changes of global cerebral blood flow (CBF) and intracranial blood flow parameters in the acute stage after CA and its correlation with patients' outcome. ⋯ Cerebral perfusion varies widely after CA. Neither hypo- nor hyperperfusion seems to be an independent risk factor for poor outcome. Duplex ultrasound of cerebral haemodynamics after CA is suitable but probably of limited prognostic value.
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Randomized Controlled Trial Comparative Study
A randomised control trial of prompt and feedback devices and their impact on quality of chest compressions-a simulation study.
This study aims to compare the effect of three CPR prompt and feedback devices on quality of chest compressions amongst healthcare providers. ⋯ CPR feedback devices vary in their ability to improve performance. In this study the pressure sensor device improved compression depth, whilst the accelerometer device reduced it and metronome had no effect.