Resuscitation
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To evaluate compliance with neonatal resuscitation guidelines during resuscitation of preterm infants by video recording of delivery room management and monitoring physiologic parameters. ⋯ Neonatal caregivers often deviate from resuscitation guidelines. Respiratory function monitoring parameters were often not used during resuscitation. A difficult part of neonatal resuscitation is subjectively assessing spontaneous breathing.
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Our primary objective was to describe and determine the feasibility of implementing a care environment targeted pediatric post-cardiac arrest debriefing program. A secondary objective was to evaluate the usefulness of debriefing content items. We hypothesized that a care environment targeted post-cardiac arrest debriefing program would be feasible, well-received, and result in improved self-reported knowledge, confidence and performance of pediatric providers. ⋯ A novel care environment targeted pediatric post-cardiac arrest pediatric debriefing program is feasible and useful for providers regardless of their participation in the resuscitation. Physical skill related elements were rated more useful than cognitive skill related elements for knowledge and performance.
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Premature infants (PRE) and infants with congenital heart disease (CHD) are at high risk for respiratory or cardiac arrest in their first year. Bystander cardiopulmonary resuscitation (CPR) is a major predictor of resuscitation outcome. The purpose of this study was to assess the usefulness of a self-instructional DVD kit (Infant CPRAnytime) for families of high-risk infants. We hypothesized that comfort level of performing CPR would increase, parents would share the kit with others, and review it during the year. ⋯ Self-instructional tools provide an excellent method of CPR training for parents of high risk infants. Caregiver comfort increased over 12 months and parents continued to review the kit during the first year. An additional 3.1 persons used the kit for CPR training.
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Comparative Study
Comparison of normal saline, hypertonic saline and hypertonic saline colloid resuscitation fluids in an infant animal model of hypovolemic shock.
Incorrect resuscitation after hypovolemic shock is a major contributor to preventable pediatric death. Several studies have demonstrated that small volumes of hypertonic or hypertonic-hyperoncotic saline can be an effective initial resuscitation solution. However, there are no pediatric studies to recommend their use. The aim of this study is to determine if in an infant animal model of hemorrhagic shock, the use of hypertonic fluids, as opposed to isotonic crystalloids, would improve global hemodynamic and perfusion parameters. ⋯ In this model of hypovolemic shock, hypertonic fluids achieved similar end-points as twice the volume of NS. Animals treated with albumin plus hypertonic saline presented prolonged increase in blood volume parameters and recovery of the oxygen debt.
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To design the core algorithm of a high-temporal resolution rhythm analysis algorithm for automated external defibrillators (AEDs) valid for adults and children. Records from adult and paediatric patients were used all together to optimize and test the performance of the algorithm. ⋯ Paediatric and adult rhythms can be accurately diagnosed using 3.2s ECG segments. A single algorithm safe for children and adults can simplify AED use, and its high temporal resolution shortens pre-shock pauses which may contribute to improve resuscitation outcome.