Resuscitation
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Randomized Controlled Trial Comparative Study
A randomized education trial of spaced versus massed instruction to improve acquisition and retention of paediatric resuscitation skills in emergency medical service (EMS) providers.
Resuscitation courses are typically taught in a massed format despite existing evidence suggesting skill decay as soon as 3 months after training. Our study explored the impact of spaced versus massed instruction on acquisition and long-term retention of provider paediatric resuscitation skills. ⋯ 3-month retention of CC skills are similar regardless of training format; however, retention of other resuscitation skills may be better when taught in a spaced format.
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Review Comparative Study
Socio-economic differences in incidence, bystander cardiopulmonary resuscitation and survival from out-of-hospital cardiac arrest: A systematic review.
Individuals with a low socioeconomic status (SES) may have a greater mortality rate from out of hospital cardiac arrest (OHCA) than those with a high SES. We explored whether SES disparities in OHCA mortality manifest in the incidence of OHCA, the chance of receiving bystander cardiopulmonary resuscitation (CPR) or in the chance of surviving an OHCA. We also studied whether sex and age differences exist in such SES disparities. ⋯ SES disparities in OHCA mortality likely manifest in OHCA incidence, bystander CPR provision and survival rate after OHCA. However, there is a distinct lack of data on SES measured at the individual level and on differences within subgroups, e.g. by sex and age.
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Intracranial pressure and compliance in hypoxic ischemic brain injury patients after cardiac arrest.
In hypoxic ischemic brain injury (HIBI), increased intracranial pressure (ICP) can ensue from cerebral edema stemming from cytotoxic and vasogenic mechanisms. Downstream sequelae of restricted cerebral blood flow lead to neurologic braindeath. There is limited data characterizing the temporal trends and patterns of ICP and compliance in human HIBI patients. ⋯ In our cohort, HIBI was characterized by normal ICP but with limited intracranial compliance. However, significant in between patient heterogeneity exists with respect to temporal patterns of intracranial pressure - volume relationships in HIBI.
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Multicenter Study
Outcome prediction of out-of-hospital cardiac arrest with presumed cardiac aetiology using an advanced machine learning technique.
Outcome prediction for patients with out-of-hospital cardiac arrest (OHCA) has the possibility to detect patients who could have been potentially saved. Advanced machine learning techniques have recently been developed and employed for clinical studies. In this study, we aimed to establish a prognostication model for OHCA with presumed cardiac aetiology using an advanced machine learning technique. ⋯ The advanced machine learning technique showed favourable prediction capability for 1-year survival of OHCA with presumed cardiac aetiology. These models can be useful for detecting patients who could have been potentially saved.
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Clinically significant deterioration of patients admitted to general wards is a recognized complication of hospital care. Rapid Response Systems (RRS) aim to reduce the number of avoidable adverse events. The authors aimed to develop a core quality metric for the evaluation of RRS. ⋯ A consensus process was used to develop ten metrics for better understanding the course and care of deteriorating ward patients. Others are proposed for further development.