Resuscitation
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Multicenter Study Clinical Trial
Impact of laryngeal tube use on chest compression fraction during out-of-hospital cardiac arrest. A prospective alternate month study.
Supraglottic devices are thought to allow efficient ventilation and continuous chest compressions during cardiac arrest. Therefore, the use of supraglottic devices could increase the chest compression fraction (CCF), a critical determinant of patient survival. The aim of this study was to assess the CCF in out-of-hospital cardiac arrest (OHCA) patients ventilated with a supraglottic device. ⋯ The use of the LT during OHCA increases the CCF when compared to standard BVM ventilation. However, the impact of LT use on mortality remains unclear.
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Advanced airway management--such as endotracheal intubation (ETI) or supraglottic airway (SGA) insertion--is one of the most prominent interventions in out-of-hospital cardiac arrest (OHCA) resuscitation. While randomized controlled trials are currently in progress to identify the best advanced airway technique in OHCA, the mechanisms by which airway management may influence OHCA outcomes remain unknown. We provide a conceptual model describing potential mechanisms linking advanced airway management with OHCA outcomes.
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Assessment skills are often neglected in resuscitation training and it has been shown that the ERC BLS/AED instructor course may be insufficient to prepare candidates for an assessment role. We have introduced an Assessment Training Programme (ATP) to improve assessors' decision making. In this article we present our ATP and an observational study of candidates' confidence levels upon completing both an ERC BLS/AED instructor course and our ATP. ⋯ The ATP raises the confidence of assessing BLS/AED candidates to a level above that of the ERC instructor course alone. We advocate that resuscitation organisations consider integrating an ATP into their existing training structure.
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To describe chest compression (CC) rate, depth, and leaning during pediatric cardiopulmonary resuscitation (CPR) as measured by two simultaneous methods, and to assess the accuracy and reliability of video review in measuring CC quality. ⋯ Video review measured CC rate accurately; depth and release were not reliably or accurately assessed by video. Future research should focus on the optimal combination of methods for measuring CPR quality.
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To evaluate CPR quality during cardiac resuscitation attempts in an urban emergency department (ED) and determine the influence of the combination of scenario-based training, real-time audiovisual feedback (RTAVF), and post-event debriefing on CPR quality. ⋯ Implementation of the bundle of scenario-based training, real-time audiovisual CPR feedback, and post-event debriefing was associated with improved CPR quality and compliance with CPR guidelines in this urban teaching emergency department.