Resuscitation
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The decision to accept or decline cardiopulmonary resuscitation (CPR) by surrogate decision makers on behalf of a family member is a common and important component of end-of-life decision-making in the ICU. While many determinants influence this decision, surrogates' understanding of CPR may be a major guiding factor. However, little is known about surrogates' knowledge and perceptions of CPR during the periods of time when their family member is critically ill. We conducted this study to explore surrogates' understanding of some basic concepts of CPR. ⋯ There is a wide variation in surrogates' understanding and knowledge of CPR concepts and outcomes.
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In the prehospital setting, advanced airway management is challenging as it is frequently affected by facial trauma, pharyngeal obstruction or limited access to the patient and/or the patient's airway. Therefore, incidence of prehospital difficult airway management is likely to be higher compared to the in-hospital setting and success rates of advanced airway management range between 80 and 99%. ⋯ In this physician-led service one out of five prehospital patients requires airway management. Incidence of advanced prehospital difficult airway management is 3.2% and eventual success rate is 99%, if performed by trained emergency physicians. A total of 1% of all prehospital intubation attempts failed and alternative airway device was necessary.
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Letter Case Reports
Intramuscolar epinephrine during neonatal resuscitation.
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Review Meta Analysis
Ultrasonography for confirmation of endotracheal tube placement: A systematic review and meta-analysis.
This study aimed to undertake a systematic review and meta-analysis to summarize evidence on the diagnostic value of ultrasonography for the assessment of endotracheal tube placement in adult patients. ⋯ Current evidence supports that ultrasonography has high diagnostic value for identifying esophageal intubation. With optimal sensitivity and specificity, ultrasonography can be a valuable adjunct in this aspect of airway assessment, especially in situations where capnography may be unreliable.
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Multicenter Study Observational Study
Cardiac arrest diagnostic accuracy of 9-1-1 dispatchers: A prospective multi-center study.
We sought to determine the ability of 9-1-1 dispatchers to accurately determine the presence of out-of-hospital cardiac arrest (OOHCA) over the telephone, and to determine the frequency with which CPR instructions are initiated and chest compressions delivered in patients not in cardiac arrest. ⋯ Dispatchers had a fair sensitivity and modest specificity for the recognition of OOHCA. We found a very small number of patients receiving CPR when not in cardiac arrest, supporting the current use of dispatch-assisted CPR instructions.