Resuscitation
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Review Meta Analysis
Predicting outcome of drowning at the scene: A systematic review and meta-analyses.
To identify factors available to rescuers at the scene of a drowning that predict favourable outcomes. ⋯ Increasing submersion duration was associated with worse outcomes. Submersion durations <5min were associated with favourable outcomes, while those >25min were invariably fatal. This information may be useful to rescuers and EMS systems deciding when to perform a rescue versus a body recovery.
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Randomized Controlled Trial
Why do some studies find that CPR fraction is not a predictor of survival?
An 80% chest compression fraction (CCF) during resuscitation is recommended. However, heterogeneous results in CCF studies were found during the 2015 Consensus on Science (CoS), which may be because chest compressions are stopped for a wide variety of reasons including providing lifesaving care, provider distraction, fatigue, confusion, and inability to perform lifesaving skills efficiently. ⋯ CCF cannot be looked at in isolation as a predictor of survival, but in the context of other resuscitation activities. When controlling for the effects of other resuscitation activities, a higher CCF is predictive of survival. This may explain the heterogeneity of findings during the CoS review.
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Randomized Controlled Trial
Viewing a brief chest-compression-only CPR video improves bystander CPR performance and responsiveness in high school students: A cluster randomized trial.
CPR training in schools is a public health initiative to improve out of hospital cardiac arrest (OHCA) survival. It is unclear whether brief video training in students improves CPR quality and responsiveness and skills retention. ⋯ Brief CPR video training resulted in improved CPR quality and responsiveness in high school students. Compression depth only improved with traditional class training. This suggests brief educational interventions are beneficial to improve CPR responsiveness but psychomotor training is important for CPR quality.
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To evaluate the diagnostic accuracy of an abrupt and sustained increase in end-tidal carbon dioxide (ETCO2) to indicate return of spontaneous circulation (ROSC) during resuscitation of patient with out-of-hospital cardiac arrest. ⋯ The feature of an abrupt rise of ETCO2 was a specific but non-sensitive marker of ROSC in patient with out-of-hospital cardiac arrest.
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Comparative Study
A Quantitative Comparison of Physiologic Indicators of Cardiopulmonary Resuscitation Quality: Diastolic Blood Pressure Versus End-Tidal Carbon Dioxide.
The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP vs. ETCO2 during CPR as predictors of cardiac arrest survival. ⋯ In both primary and asphyxia-associated VF porcine models of cardiac arrest, DBP discriminates survivors from non-survivors better than ETCO2. Failure to attain a DBP >34mmHg during CPR is highly predictive of non-survival.