Resuscitation
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Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. ⋯ Our results suggest that shift work may impact EM resident resuscitation performance, particularly in the communication domain. This impact may be more significant in women than men, suggesting a need for further investigation.
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Randomized Controlled Trial Multicenter Study
Burden of caregiving after a child's in-hospital cardiac arrest.
To describe caregiver burden among those whose children survive in-hospital cardiac arrest and have high risk of neurologic disability, and explore factors associated with burden during the first year post-arrest. ⋯ Caregiver burden is substantial during the first year after paediatric in-hospital cardiac arrest, and associated with the extent of the child's neurobehavioural dysfunction.
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Drowning literature have highlighted the submersion time as the most powerful predictor in assessing the prognosis. Reducing the time taken to provide a flotation device and prevent submersion appears of paramount importance. Unmanned aerial vehicles (UAVs) can provide the location of the swimmer and a flotation device. ⋯ UAV can deliver a flotation device to a swimmer safely and quickly. The addition of a UAV in rescue operations could improve the quality and speed of first aid while keeping lifeguards away from dangerous sea conditions.
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Cardiac arrest effectiveness trials have traditionally reported outcomes that focus on survival. A lack of consistency in outcome reporting between trials limits the opportunities to pool results for meta-analysis. The COSCA initiative (Core Outcome Set for Cardiac Arrest), a partnership between patients, their partners, clinicians, research scientists, and the International Liaison Committee on Resuscitation, sought to develop a consensus core outcome set for cardiac arrest for effectiveness trials. ⋯ Published by Elsevier B. V. All rights reserved.
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Observational Study
Preliminary observations in systemic oxygen consumption during targeted temperature management after cardiac arrest.
Limited data suggests low oxygen consumption (VO2), driven by mitochondrial injury, is associated with mortality after cardiac arrest. Due to the challenges of measurement in the critically ill, post-arrest metabolism remains poorly characterized. We monitored VO2, carbon dioxide production (VCO2) and the respiratory quotient (RQ) in post-arrest patients and explored associations with outcome. ⋯ There was a significant association between VO2 and mortality in the first 12 h after ROSC, but not over 24 h. Lower VO2: lactate ratio was associated with mortality. A large percentage of patients had RQs below physiologic norms. Further research is needed to explore whether these parameters could have true prognostic value or be a potential treatment target.