Resuscitation
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Interruptions in compressions reducethe efficacy of cardiopulmonary resuscitation (CPR) and are inevitable during hands-off periods for shocks. Clinical exam gloves were found to facilitate safe contact with patients during shock delivery but the safety of this practice has been questioned. Polyethylene is of interest because of its safety record in the medical arena and its electrical insulation properties. ⋯ Polyethylene is a common medical material which may facilitate safe hands-on defibrillation. Our data illustrates that a thin, semitransparent layer of polyethylene is a safe and feasible adjunct to cardiac arrest kits to allow continued compressions and simplification of the CPR process.
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Review Meta Analysis
A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children.
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest. ⋯ These results support the recommendation that dispatchers provide CPR instructions to callers for adults and children with suspected OHCA. Review registration: PROSPERO- CRD42018091427.
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Fifty years ago, the ad hoc committee of the Harvard medical school provided the influential first guidance on confirming death using neurological criteria (DNC). Now 70% of countries have a legal or professional framework enabling DNC. ⋯ The legacy of the Harvard ad hoc committee has been a continuing development of our concepts of human death. There is a growing acceptance that ultimately all human death is brain based whether diagnosed using neurological criteria or using circulatory criteria after cardiac arrest.
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We investigated the mechanism and extent of myocardial injury associated with out-of-hospital cardiac arrest (OHCA). ⋯ Significant myocardial injury associated with OHCA occurs in the presence of acute culprit lesion while extent of myocardial injury in stable or absent coronary disease is significantly smaller and correlates with the duration and intensity of cardiac resuscitation. Admission cTnI, although combined with post-resuscitation ECG, have insufficient accuracy to securely predict presence of acute culprit lesion.