Resuscitation
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Randomized Controlled Trial
Effects of audio tone guidance on performance of CPR in simulated cardiac arrest with an advanced airway.
Despite the emphasis of cardiopulmonary resuscitation (CPR) quality, the performance of on-site CPR is reported to be frequently unsuccessful. In order to improve CPR quality, various feedback systems have been developed, but they have not yet been widely used on site due to low economic efficiency. The present study was attempted to determine whether CPR quality can be improved using audio tone guidance. ⋯ Audio tone guidance ensures better chest compression rate and ventilation rate but this does not necessarily result in a better CPR quality.
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Primarily, to investigate induction of therapeutic hypothermia during prehospital cardiopulmonary resuscitation (CPR) using ice-cold intravenous fluids. Effects on return of spontaneous circulation (ROSC), rate of rearrest, temperature and haemodynamics were assessed. Additionally, the outcome was followed until discharge from hospital. ⋯ Induction of therapeutic hypothermia during prehospital CPR and after ROSC using ice-cold Ringer's solution effectively decreased nasopharyngeal temperature. The treatment was easily carried out and well tolerated.
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The most recent Neonatal Resuscitation Programme (NRP 5th edition) guidelines recognise the T-piece resuscitator (Neopuff) device as an acceptable method of administering a pre-selected peak inspiratory pressure (PIP) and positive end expiratory pressure (PEEP). While these are constant, other parameters are operator-dependent. ⋯ This study showed that despite fixed inflating pressures, less experienced operators used prolonged inspiratory times. Wide variation in mean airway pressure and tidal volume were seen in all operators.
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The aim of the study was to provide an accurate account of current practice of laryngeal mask airway (LMA) use within SA Ambulance Service (SAAS) and identify issues that could lead to constructive training for paramedics and improve clinical care and patient safety. ⋯ This clinical audit provides a comprehensive account of LMA use within SA Ambulance Service. Although the current practice was found to be acceptable, these results are below those of comparable groups and should be improved upon.
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The response of the human body to cardiac arrest (CA) and cardiopulmonary resuscitation is characterised by excessive coagulation, inadequate endogenous anti-coagulation and fibrinolysis as well as an inflammatory syndrome that closely resembles the immunological profile observed in patients with sepsis. Recombinant human activated protein C (rhAPC) has been found to be protective in severe sepsis and in animal models of stroke and spinal cord injury. In the present study, we evaluated the effects of rhAPC on neurological outcome after CA in rats. ⋯ A clear and lasting effect of rhAPC on neurological outcome or inflammation after CA could not be shown in this study but the detailed analysis of the postresuscitation syndrome given here builds a firm basis for further research.