Resuscitation
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Comparative Study Observational Study
Cardiopulmonary Resuscitation by Trained Responders Versus Lay Persons and Outcomes of Out-of-Hospital Cardiac Arrest: A Community Observational Study.
The study aims to compare bystander processes of care (cardiopulmonary resuscitation (CPR) and defibrillation) and outcomes for witnessed presumed cardiac etiology in OHCA patients in whom initial resuscitation was provided by dedicated trained responder (TR) versus lay person (LP) bystanders. ⋯ The TR group witnessed a relatively low proportion of OHCA but was associated with better survival outcomes and good neurological recovery through higher CPR rates and defibrillation of adults older than 15 years with witnessed OHCA in a metropolitan city.
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An increasing number of failing automated external defibrillators (AEDs) is reported: AEDs not giving a shock or other malfunction. We assessed to what extent AEDs are 'failing' and whether this had a device-related or operator-related cause. ⋯ Errors associated with AED use are rare (4%) and when occurring are in 72% caused by the operator or circumstances of use. Fully automatic AEDs may prevent the majority of these errors.
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Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. ⋯ There is a significant difference between time of deterioration to initiation of chest compressions and the time of recognition to initiation of chest compressions. Resuscitation records should be modified to include more information about the actual timing of patient deterioration.
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Editorial Comment
Saving lives despite 'failed' extracorporeal resuscitation.
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Letter Case Reports
Asphyxia after complete avalanche burial: A new paradigm.