Resuscitation
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Review Meta Analysis
Delayed versus immediate defibrillation for out-of-hospital cardiac arrest due to ventricular fibrillation: A systematic review and meta-analysis of randomised controlled trials.
Human studies over the last decade have indicated that delaying initial defibrillation to allow a short period of cardiopulmonary resuscitation (CPR) may promote a more responsive myocardial state that is more likely to respond to defibrillation and result in increased rates of restoration of spontaneous circulation (ROSC) and/or survival. Out-of-hospital studies have produced conflicting results regarding the benefits of CPR prior to defibrillation in relation to survival to hospital discharge. The aim of this study was to conduct a systematic review and meta-analysis of randomised controlled trials comparing the effect of delayed defibrillation preceded by CPR with immediate defibrillation on survival to hospital discharge. ⋯ Delaying initial defibrillation to allow a short period of CPR in out-of-hospital cardiac arrest due to VF demonstrated no benefit over immediate defibrillation for survival to hospital discharge irrespective of response time. There is no evidence that CPR before defibrillation is harmful. Based on the existing evidence, EMS jurisdictions are justified continuing with current practice using either defibrillation strategy.
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Randomized Controlled Trial Comparative Study
Comparison of instructor-led automated external defibrillation training and three alternative DVD-based training methods.
Self-directed BLS-training, using a personal training manikin with video has been shown to be as effective as instructor-led training. This has not previously been investigated for AED-training. ⋯ DVD-based AED-training without scenario is not recommended. Scenario training is a useful addition, but instructor-facilitated training remains the best method.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of two intraosseous access devices in adult patients under resuscitation in the emergency department: A prospective, randomized study.
Current guidelines recommend intraosseous (IO) vascular access in adults if peripheral venous access is unavailable. Most available data derive from children, animal models, cadaver studies or the prehospital setting. Therefore we compared two different IO access devices in adults under resuscitation in the hospital setting. ⋯ IO vascular access was a reliable and safe method to gain rapid vascular access for in-hospital adult emergency patients under resuscitation. Further studies are necessary regarding comparative effectiveness of different IO devices.