Resuscitation
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Observational Study
Impact of cardiopulmonary resuscitation duration on survival from paramedic witnessed out-of-hospital cardiac arrests: An observational study.
Resuscitation guidelines often recommend ongoing cardiopulmonary resuscitation (CPR) efforts to hospital for out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical service (EMS) personnel. In this study, we examine the relationship between EMS CPR duration and survival to hospital discharge in EMS witnessed OHCA patients. ⋯ Resuscitation efforts exceeding 32 min yielded less than 1% of survivors from EMS witnessed OHCA. On the basis of this data, EMS witnessed OHCA patients may benefit from ongoing CPR efforts up to 48 min in duration.
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Observational Study
Hospital overnight and evaluation of systems and timelines study: a point prevalence study of practice in Australia and New Zealand.
Diurnal variation in the performance of rapid response systems has not been fully elucidated. Afferent limb failure (ALF) is a significant problem and is an important measure of performance of rapid response systems. ⋯ The prevalence of ALF amongst patients admitted to the ICU from the ward is high. SBP is the least recorded patient observation. This study was unable to identify a diurnal variation in the prevalence of ALF, its consequences (i.e. mortality) and the completeness of patient observations. Observational studies with a larger sample are required to explore this important problem.
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Europe is a patchwork of 47 countries with legal, cultural, religious, and economic differences. A prior study suggested variation in ethical resuscitation/end-of-life practices across Europe. This study aimed to determine whether this variation has evolved, and whether the application of ethical practices is associated with emergency care organisation. ⋯ According to key experts, ethical practices and emergency care still vary across Europe. There is need for harmonised legislation, and improved, education-based interpretation/application of bioethical principles. Better application of ethical practices may be associated with improved emergency care organisation.
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Letter Case Reports
Ventricular fibrillation and consciousness are not mutually exclusive.