Resuscitation
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The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. ⋯ In patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30days.
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Observational Study
Regional cerebral saturation monitoring during withdrawal of life support until death.
The aim of this pilot study was to explore the regional cerebral oxygen saturation (rSO2) during the process of dying in Intensive Care Unit (ICU) patients in whom it was decided to withdraw life support. ⋯ A continuous and patient specific decrease in rSO2 was observed in all patients with a simultaneous decrease in MAP. However, the absolute rSO2 value at moment death was clinically determined, had a broad range, indicating that there is no clear cut-off rSO2 value for death probably due to the heterogeneity of the studied population. Taken together, these observations highlight the importance of following trends and comparing rSO2 values in the cardiac arrest setting.
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The work context of the general practitioner (GP) potentially lends itself to the provision of early community based, cardiac arrest care. GPs have traditionally encountered out of hospital cardiac arrest (OHCA) as a component of routine patient care but have not been formally linked with the statutory ambulance service. Computer aided dispatch technology now allows real time GP text message alert to nearby cardiac arrest events. ⋯ Text alert activation of GPs to nearby OHCA events has proven feasible, with significant activity during the establishment period, but a low survival rate which is similar to the overall national OHCA survival rate. A high proportion of alerts do not involve resuscitation opportunities.
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To investigate the epidemiology and outcomes of cardiac arrests associated with opioid overdoses. Recent data suggest that drug overdoses are responsible for more deaths than motor vehicle crashes or firearms in the United States each year, with opioids being involved in majority of drug overdose deaths. Despite the potential for opioids to cause cardiac arrest, few studies have examined this association. ⋯ Cardiac arrest is more common in patients with opioid overdoses in comparison to non-opioid overdoses. The rate of cardiac arrest is increasing disproportionately in patients with opioid overdoses. Opioid overdoses are independent risk factors for both cardiac arrest and mortality in patients with overdoses.
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The World Health Organization's endorsement of the "Kids save lives" statement fosters the implementation of cardiopulmonary resuscitation (CPR) training for school children worldwide. However, not every child achieves and maintains the recommended chest compression depth of 5-6cm. ⋯ A minimal excellence level of 25% is achievable by boys 12-14year and girls 14-16year and can be gradually improved to 60% and 90% according to age and gender. This might necessitate more exertion and training for some younger children, especially girls, and will probably be more easily achieved for children weighing >50kg.