Resuscitation
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The success rate of cardiopulmonary resuscitation (CPR) for cancer patients following in-hospital cardiac arrest has remained poor over the last 3 decades, but little is known about determinants of undergoing CPR for these patients at the end of life. ⋯ One-tenth of Taiwanese cancer patients underwent CPR in the last month of life, and the rates of CPR decreased substantially from 2001 to 2006. The propensity for CPR was influenced by patient demographics, disease characteristics, physician specialty, and teaching status of the patient's primary hospital.
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The aim of this study was to evaluate the effect of multi-professional full-scale simulation-based education of staff on the mortality and staff awareness of patients at risk on general wards. DESIGN, SETTINGS AND PATIENTS: A prospective before-and-after study conducted on four general wards at Herlev Hospital, Denmark. In the pre-intervention period (June-July 2006) and post-intervention period (November-December 2007), all patients on the wards had vital signs measured in the evening by study personnel, who also asked nursing staff questions about patients with abnormal vital signs. The mortality of patients with abnormal vital signs was registered from the hospital database. Simplified medical emergency team calling criteria were used to define abnormal vital signs. ⋯ This multi-professional education of staff did not affect the rate of mortality or staff awareness of patients at risk on the wards.
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Comparative Study
Can experienced paramedics perform tracheal intubation at cardiac arrests? Five years experience of a regional air ambulance service in the UK.
Paramedic tracheal intubation has been reported to carry a high failure rate and morbidity. A comparison between doctor and paramedic-led intubation at out-of-hospital cardiac arrests (OHCA) was conducted to assess whether this finding was observed in our clinical practice. ⋯ Experienced paramedics regularly operating with physicians have a low tracheal intubation failure rate at OHCA, whether practicing independently or as part of a doctor-led team. This is likely due to increased and regular clinical exposure.
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We sought to compare the effects of conservative hypotensive and aggressive normotensive resuscitation strategies on blood loss, fluid requirements, blood lactate and survival rate in a clinically relevant model of uncontrolled hemorrhagic shock in pregnancy. ⋯ We conclude that in this rabbit model of uncontrolled hemorrhage in pregnancy, hypotensive resuscitation to MAP of 60mmHg may be an optimal target MAP before hemorrhage can be controlled by surgical intervention.