Resuscitation
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Hypocalcemia associated with cardiac arrest has been reported. However, mechanistic hypotheses for the decrease in ionized calcium (iCa) vary and its importance unknown. The objective of this study was to assess the relationships of iCa, pH, base excess (BE), and lactate in two porcine cardiac arrest models, and to determine the effect of exogenous calcium administration on post-resuscitation hemodynamics. ⋯ Ionized hypocalcemia occurs following ROSC. CaCl(2) improves post-ROSC hemodynamics suggesting that hypocalcemia may play a role in early post-resuscitation myocardial dysfunction.
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To examine interventions and timing of emergency team calls in hospitals with or without a medical emergency team (MET). ⋯ Nearly all emergency team calls required critical care type interventions. Emergency team calls show a unique temporal pattern for both MET and control hospitals. These findings have important organizational and resource-related implications for hospitals evaluating and establishing rapid response systems.
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Randomized Controlled Trial
Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback.
Automated verbal and visual feedback improves quality of resuscitation in out-of-hospital cardiac arrest and was proven to increase short-term survival. Quality of resuscitation may be hampered in more difficult situations like emergency transportation. Currently there is no evidence if feedback devices can improve resuscitation quality during different modes of transportation. ⋯ Real time automated feedback improves certain aspects of CPR quality in flying helicopters and moving ambulance vehicles. The effect of feedback guidance was most pronounced for chest compression rate.
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Comparative Study
Tracheal temperature for monitoring body temperature during mild hypothermia in pigs.
Out-of-hospital induction of mild therapeutic hypothermia after cardiac arrest needs easy to use and accurate body temperature monitoring. The aim of the study was to evaluate the best temperature probe position on a specially designed tracheal tube, as compared to pulmonary artery temperature (Tpa) during cooling to mild hypothermia in pigs. ⋯ Tracheal temperature is an accurate surrogate for body temperature during fast and slow cooling to mild hypothermia in pigs and regardless of the location of the temperature probe on the tube.