Resuscitation
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Neurologic prognostication after cardiac arrest relies on clinical examination findings derived before the advent of therapeutic hypothermia (TH). We measured the association between clinical examination findings at hospital arrival, 24, and 72 h after cardiac arrest in a modern intensive care unit setting. ⋯ GCS Motor score < or = 3 or < or = 2 at 24 or 72 h following cardiac arrest does not exclude survival or good outcome. However, absent pupil or corneal response at 72 h appears to exclude survival and good outcome.
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Video-based self-instruction (VSI) with a 24-min DVD and a personal resuscitation manikin solves some of the barriers associated with traditional basic life support (BLS) courses. No accurate assessment of the actual improvement in skills after attending a VSI course has been determined, and in this study we assess the skill improvement in laypersons undergoing VSI. ⋯ Untrained laypersons attending a 24 min DVD-based BLS course have a significantly improved BLS performance after 3 1/2-4 months compared to pre-test skill performance. Especially the total number of compressions improved and the hands-off time decreased.
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To determine cardioversion doses of biphasic DC shock for paediatric atrial dysrhythmias. ⋯ In rounded doses, recommended initial external cardioversion doses are 0.5-1.0 J/kg and subsequently up to 2 J/kg, internal cardioversion doses are 0.5 J/kg.
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Comparative Study
Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compressions: a manikin study.
If tracheal intubation can be performed during uninterrupted chest compressions, this will sustain circulation during the procedure of intubation and may lead to successful resuscitation. We compared three types of laryngoscope on a manikin as to whether they enabled tracheal intubation while the manikin's chest was rhythmically compressed. ⋯ These results suggest that the use of the Pentax-AWS enables tracheal intubation while the patient's chest is rhythmically compressed, and would more often lead to successful intubation, which in turn may lead to more successful resuscitation.
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Food asphyxiation is uncommon but unignorable cause of sudden death in the elderly. Several autopsy studies, which identified those at particular risk, have been conducted on the subject. Resuscitation profiles and outcomes of food asphyxiation victims presenting with out-of-hospital cardiac arrest (OHCA) to the emergency department, however, have rarely been reported. ⋯ Because of their advanced age and debilitating general condition, it may be difficult to substantially improve the outcomes of food asphyxiation victims. Effort should be directed to prevent food asphyxiation, and public education to perform standard CPR for food asphyxiation victims including the Heimlich manoeuvre is warranted.