Resuscitation
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The LUCAS 2 device stores technical data that documents the chest compression process. We analyzed chest wall dimensions and mechanics stored during chest compressions on humans using data gathered with the LUCAS 2 device. ⋯ There was a large variation of the required force to achieve a compression depth of 53 mm. No correlation was seen between chest height and maximum force required to compress the chest 53 mm.
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Emergency research is necessary to prevent exposure of patients to unvalidated clinical practice (nonmaleficence), and to improve the dismal prognosis of disorders requiring emergent treatment such as cardiac arrest (beneficence). Regulations that govern clinical research should conform to bioethical principles of respect for nonmaleficence, beneficence, autonomy, and justice. Our objectives are to review the evolution of European Union (EU) legislation on emergency research, and to identify potentially remaining problems. ⋯ Legislation related to emergency research in Europe has evolved to increase concordance with bioethical principles so as to increase evidence-based improvements in emergency care.
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Extracorporeal cardiopulmonary resuscitation (ECPR) promises to be an important advance in the treatment of cardiac arrest. However, ECPR involves ethical challenges that should be addressed as it diffuses into practice. ⋯ To inform decision making, patients' preferences regarding ECPR should be obtained, both from the general population and from inpatients at risk for cardiac arrest. Fair and transparent appropriate use criteria should be developed and could be informed by economic analyses.