Resuscitation
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Magnesium sulfate in the treatment of refractory ventricular fibrillation in the prehospital setting.
To determine if magnesium sulfate (MgSO(4)) improves outcome in cardiac arrest patients initially in ventricular fibrillation (VF). ⋯ We failed to demonstrate that the administration of 2 g of MgSO(4) to prehospital cardiac arrest patients presenting in VF improves short or long term survival.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Optimal Response to Cardiac Arrest study: defibrillation waveform effects.
Advances in early defibrillation access, key to the "Chain of Survival", will depend on innovations in defibrillation waveforms, because of their impact on device size and weight. This study compared standard monophasic waveform automatic external defibrillators (AEDs) to an innovative biphasic waveform AED. ⋯ ICBTE was superior to MTE and MDS in defibrillation efficacy and speed and to MTE in ROSC. MTE and MDS did not differ in efficacy. There were no differences among the waveforms in refibrillation or survival.
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Randomized Controlled Trial Comparative Study Clinical Trial
Endobronchial application of high dose epinephrine in out of hospital cardiopulmonary resuscitation.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of manikin CPR performance by lay persons trained in three variations of basic life support guidelines.
This paper reports on a randomised controlled trial comparing the acquisition and retention of cardiopulmonary resuscitation (CPR) skills by lay persons trained in three variations of basic life support. Training was provided either in 1992 European Resuscitation Council (ERC) guidelines, or in the 1997 International Liaison Committee on Resuscitation (ILCOR) Advisory Statement (adopted with minor revisions as 1998 ERC guidelines), and an American Heart Association 'call first' version of the 1997 ILCOR statement. Evaluation of manikin CPR using the established Cardiff tests (CARE and VIDRAP) showed that 51% of those trained in the current ILCOR guidelines performed effectively compared with 38% trained in the ERC 1992 guidelines and 25% trained in the 'call first' variation (P<0.01). Whilst the current ERC and ILCOR guidelines appeared easiest to learn, retention at 6 months was poor (14% effective) irrespective of method.
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Randomized Controlled Trial Comparative Study Clinical Trial
Arterial blood-gases with 500- versus 1000-ml tidal volumes during out-of-hospital CPR.
The correct tidal volume during cardiopulmonary resuscitation (CPR) is presently debated. While the European Resuscitation Council (ERC) and American Heart Association (AHA) previously recommended a tidal volume of 800-1200 ml, the ERC has recently reduced this to 400-600 ml. In a prospective, randomised study of 17 non-traumatic out-of-hospital cardiac arrest patients intubated and mechanically ventilated 12 min(-1) with 100% oxygen, we have therefore compared arterial blood gases generated with tidal volumes of 500 and 1000 ml. ⋯ We conclude that arterial normocapnia is not achieved with either tidal volume during advanced life support with non-rebreathing ventilation at 12 min(-1). What ventilation volume is required for CO(2) removal and oxygenation during basic life support with mouth-to-mouth ventilation cannot be extrapolated from the present data. In that situation the risk of gastric inflation, regurgitation and aspiration must also be taken into account.