Resuscitation
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Comparative Study
Comparison of two instructional modalities for nursing student CPR skill acquisition.
The purpose of the study was to compare performance based measures of CPR skills (compressions, ventilations with bag-valve-mask (BVM), and single rescuer CPR) from two types of CPR courses: a computer-based course (HeartCode BLS) with voice advisory manikin (VAM) feedback and instructor-led (IL) training with traditional manikins. ⋯ Students who trained using HeartCode BLS and practiced with VAMs performed more compressions with adequate depth and ventilations with adequate volume than students who had IL courses. Results of this study provide evidence to support use of HeartCode BLS with VAM for training nursing students in CPR.
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Comparative Study
Experiences of sudden cardiac arrest survivors regarding prognostication and advance care planning.
We sought to better understand SCA survivors' beliefs about complex issues that arise in the immediate post-arrest period and explore advance care planning. Specifically, we wished to explore four themes: (1) patient and family perception of medical providers' prognostication in the immediate post-arrest phase; (2) patient definitions of death; (3) use of advance directives (ADs); and (4) perceptions of health and organ donation. ⋯ Our study elucidated the attitudes and experiences of SCA survivors. Variability in prognostication timing and inconsistency in describing SCA can complicate discussions between the medical team and families. AD and organ donation discussions may help to provide sensitive care concordant with a patient's wishes.
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Comparative Study
ViEWS--Towards a national early warning score for detecting adult inpatient deterioration.
To develop a validated, paper-based, aggregate weighted track and trigger system (AWTTS) that could serve as a template for a national early warning score (EWS) for the detection of patient deterioration. ⋯ We have developed a simple AWTTS - ViEWS - designed for paper-based application and demonstrated that its performance for predicting mortality (within a range of timescales) is superior to all other published AWTTSs that we tested. We have also developed a tool to provide a relative measure of the number of "triggers" that would be generated at different values of EWS and permits the comparison of the workload generated by different AWTTSs.
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We aimed to describe the epidemiological features and to determine the predictors for survival to discharge of non-traumatic out-of-hospital cardiac arrest (OHCA) in Korea. ⋯ From a nationwide OHCA cohort, the incidence of EMS-assessed non-traumatic OHCA was found to be low. Survival-to-discharge rate in the resuscitation-attempted group was 3.5%, which was significantly associated with witnessed arrest, and shorter BLS and EMS intervals.
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Case Reports
Intravenous fat emulsion to reverse haemodynamic instability from intentional amitriptyline overdose.
We report the first case of amitriptyline toxicity treated with intravenous fat emulsion (IFE). Toxicity was manifested as vasopressor-refractory haemodynamic instability despite standard therapy. Our patient recovered with no adverse effects noted.