Resuscitation
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Observational Study
Lidocaine versus Amiodarone for Pediatric In-Hospital Cardiac Arrest: An Observational Study.
Lidocaine and amiodarone are both included in the pediatric cardiac arrest guidelines as treatments of shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, although there is limited evidence to support this recommendation. ⋯ In children with cardiac arrest receiving antiarrhythmics for a shockable rhythm, there was no significant difference in clinical outcomes between those receiving lidocaine compared to amiodarone.
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There has been an explosive growth of ECPR within new and established ECMO programs worldwide with the concomitant need for simulation trainers. However, current commercially available ECMO simulation models are expensive and lack many standard cardiorespiratory resuscitative (CPR) features. ⋯ A novel in-house modified manikin for ECPR was developed that was cost-efficient and realistic to use from first response through to establishment of ECMO circulation.
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Observational Study
Association between health insurance status and transfer of patients with return of spontaneous circulation after out-of-hospital cardiac arrest.
To explore the factors related to the probability of inter-hospital transfer to a heart attack centre in patients with return of spontaneous circulation after out-of-hospital cardiac arrest (OHCA) in the Republic of Korea. ⋯ Socioeconomic status appears likely to influence the probability of transfer to a heart attack centre after resuscitation.
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Epinephrine in Children Receiving Cardiopulmonary Resuscitation for Bradycardia with Poor Perfusion.
To determine whether the use of epinephrine in pediatric patients receiving cardiopulmonary resuscitation for bradycardia and poor perfusion was associated with improved clinical outcomes. ⋯ In children receiving cardiopulmonary resuscitation for bradycardia with poor perfusion, epinephrine was associated with worse outcomes, although the study does not eliminate the potential for confounding.
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Observational Study
The association between nurse staffing levels and a failure to respond to patients with deranged physiology: A retrospective observational study in the UK.
Responding to abnormalities in patients' vital signs is a fundamental aspect of nursing. However, failure to respond to patient deterioration is common and often leads to adverse patient outcomes. This study aimed to determine the association between Registered Nurse (RN) and Nursing Assistant (NA) staffing levels and the failure to respond promptly to patients' abnormal physiology. ⋯ RN, but not NA, staffing levels influence the rates of failure to respond for patients with the most abnormal vital signs (NEWS values ≥ 7). These findings offer a possible explanation for the increasingly reported association between low RN staffing and an increased risk of patient death during a hospital admission.