Resuscitation
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Randomized Controlled Trial Comparative Study
Out-of hospital advanced life support with or without a physician: effects on quality of CPR and outcome.
The presence of physicians is believed to facilitate optimal management of out-of-hospital cardiac arrest, but has not been sufficiently documented. ⋯ Survival after out-of-hospital cardiac arrest was not different for patients treated by the PMA and non-PMA in our EMS system.
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Multicenter Study Comparative Study
Cardiac arrest in Irish general practice: an observational study from 426 general practices.
Sudden Cardiac Death accounts for approximately 5000 deaths in Ireland each year. Nationally, out-of-hospital cardiac arrest has a very low resuscitation rate, reported at less than 5%. Ireland has a well developed general practice network which routinely manages emergencies arising in the community setting. However, little is known about its potential impact on Sudden Cardiac Death. This study reports on the incidence and management of cardiac arrest in Irish general practice. ⋯ Cardiac arrest in general practice is compatible with structured, effective interventions and significant rates of successful resuscitation. All general practices should be capable of providing this care.
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Randomized Controlled Trial Comparative Study
"Mouth to mouth ventilation": a comparison of the laryngeal mask airway with the Laerdal Pocket Facemask.
Ten nurses with basic airway management experience were formally trained to use a classic laryngeal mask airway (LMA) and a Laerdal Pocket Facemask (LPFM) for oxygen enriched expired air ventilation (EEAV). They then used both of these devices for EEAV in a randomised fashion in 100 anaesthetised ASA I/II patients for elective surgery. EEAV was considered successful if the patient's arterial oxygen saturation was maintained above 93% on room air for 3 min. ⋯ There was no apparent learning curve for either apparatus. Mean time in seconds (s) for first successful ventilation from picking up the apparatus was 26.8s and 15.1s, for the LMA and LPFM respectively (P<0.005). Although the LMA took significantly longer time to insert, it proved to be more successful and easier to use than the LPFM for EEAV.
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Comparative Study
Assessment of intravascular volume by transthoracic echocardiography during therapeutic hypothermia and rewarming in cardiac arrest survivors.
To study haemodynamic effects and changes in intravascular volume during hypothermia treatment, induced by ice-cold fluids and maintained by ice-packs followed by rewarming in patients after resuscitation from cardiac arrest. ⋯ Our results support the hypothesis that inducing hypothermia following cardiac arrest, using cold intravenous fluid infusion does not cause serious haemodynamic side effects. Serial transthoracic echocardiographic estimation of intravascular volume suggests that many patients are hypovolaemic during therapeutic hypothermia and rewarming in spite of a positive fluid balance.
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Comparative Study
Quantitative analysis of chest compression interruptions during in-hospital resuscitation of older children and adolescents.
To quantitatively describe pauses in chest compression (CC) delivery during resuscitation from in-hospital pediatric and adolescent cardiac arrest. We hypothesized that CPR error will be more likely after a chest compression provider change compared to other causes for pauses. ⋯ Provider switches account for a significant portion of no-flow time. Measurable residual leaning is more likely after provider switch. Feedback systems may allow some providers to continue high quality CPR past the recommended switch time of 2 min during in-hospital resuscitation attempts.