Resuscitation
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Unplanned admission to an intensive care unit (ICU) is associated with high mortality, having the highest incidence among patients who are emergency admissions to the hospital. This study was designed to identify factors associated with unplanned ICU admission in emergency admissions to hospital and develop an absolute risk tool to individualise the risk of an event during a hospital stay. ⋯ This study identified factors associated with unplanned ICU admission and developed a nomogram to individualise risk prior to a patient being transferred from the ED. This nomogram provides clinicians the opportunity prior to transfer from the ED, to either (1) review the appropriateness of the ward level of planned transfer or (2) flag patients for follow-up on the general ward to assess for deterioration.
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Multicenter Study Comparative Study
Analysis of medical emergency team calls comparing subjective to "objective" call criteria.
To explore the reasons why nursing staff use the subjective "worried" Medical Emergency Team (MET) calling criterion and compare the outcomes of calls activated using the "worried" criterion with those calls activated using "objective" criteria such as vital sign abnormalities. ⋯ The "worried" criterion was the most frequent reason for MET calls, implying a high degree of empowerment and independent action by nursing staff. Low SpO2 and respiratory distress were the most common causes for concern. There was a significant difference between MET calls triggered by "worried" criteria and "objective" criteria for outcomes immediately following MET (p < 0.001). Further assessment and refinement of MET triggers particularly in relation to respiratory distress and pulse oximetry may be needed.
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Randomized Controlled Trial
Reduced hands-off-time and time to first shock in CPR according to the ERC Guidelines 2005.
Chest compressions and early defibrillation are crucial in cardiopulmonary resuscitation (CPR). The Guidelines 2005 brought major changes to the basic life support and automated external defibrillator (BLS-AED) algorithm. We compared the European Resuscitation Council's Guidelines 2000 (group '00) and 2005 (group '05) on hands-off-time (HOT) and time to first shock (TTFS) in an experimental model. ⋯ In this manikin setting, HOT and TTFS improved with BLS-AED performed according to Guidelines 2005.
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Randomized Controlled Trial
Effect of cooling after human cardiac arrest on myocardial infarct size.
The Hypothermia after Cardiac Arrest (HACA) trial assessed whether mild therapeutic hypothermia improved the rate of good neurological recovery in patients after ventricular fibrillation cardiac arrest of presumed cardiac origin. We evaluated the impact of hypothermia on myocardial injury. ⋯ Cooling after successful resuscitation for ventricular fibrillation cardiac arrest did not influence infarct size. Cautious interpretation of the subgroup analysis may indicate a favourable trend for early cooling.