Resuscitation
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Randomized Controlled Trial
Using a smartphone application (PocketCPR) to determine CPR quality in a bystander CPR scenario - a manikin trial.
Feedback devices and dispatcher assistance increase CPR quality in bystander resuscitation. Yet, there is no data comparing both approaches with uninstructed CPR. The present prospective, randomized, controlled, manikin trial aims to determine the effects of the use of a smartphone application (PocketCPR) on CPR quality in a bystander CPR scenario compared to dispatcher-assisted telephone CPR and uninstructed CPR. ⋯ Feedback by a smartphone application can improve bystander CPR quality in terms of no-flow-time, compression rate, correct hand position, thorax release and does not delay CPR onset. However, the use of a smartphone application does not improve compression depth significantly.
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Implantable cardioverter-defibrillators (ICDs) are a well-established therapy for patients at risk of life-threatening ventricular arrhythmias. With rising implant rates, the risk of a rescuer performing chest compressions during discharge is increasing, leading to concerns over rescuer safety from the resultant leakage current. More recently, subcutaneous ICDs (S-ICD) have been developed, which utilise a higher energy and more superficial electrodes compared with transvenous ICDs (T-ICD), raising safety concerns further. ⋯ Rescuers performing chest compressions on ICD patients are at risk from leakage current, particularly from S-ICDs. Chest compressions should be performed from the opposite side to the ICD to reduce rescuer risk.
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Quantitative waveform measures are a surrogate of the acute physiological status of the myocardium and predict survival following ventricular fibrillation out-of-hospital cardiac arrest (OHCA). We investigated whether the amplitude spectrum area (AMSA) waveform measure mediates the adverse relationship between increasing burden of chronic health conditions and lower likelihood of survival. ⋯ The waveform measure AMSA - a surrogate for the physiological status of the myocardium - mediated only a modest portion of the association between increasing burden of chronic health conditions and lower likelihood of survival following ventricular fibrillation OHCA.
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The design and implementation of a wearable training device to improve cardiopulmonary resuscitation (CPR) is presented. ⋯ The system allows for portable, real-time feedback for use in training and in the field, and shows promise toward classifying and improving the administration of CPR.
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Aortic stenosis is an independent predictor for outcome in patients with in-hospital cardiac arrest.
Prognostic tools for decision-making whether to continue advanced life support or limit life sustaining interventions in In-Hospital Cardiac Arrest (IHCA), remain scarce and inconclusive. In this regard it seems intuitive that the presence of aortic stenosis (AS) impacts on both central and peripheral perfusion during resuscitative attempts and might worsen outcome. Therefore, we aimed to investigate the prognostic value of AS on outcome after IHCA. ⋯ AS proved to be a strong and independent predictor for mortality and poor outcome after IHCA. Therefore, the presence of AS mirrors an easily available predictive tool for risk stratification and decision-making.