Resuscitation
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Randomized Controlled Trial
Chest compression quality and rescuer fatigue with increased compression to ventilation ratio during single rescuer pediatric CPR.
The effects of the recommended 30:2 compression:ventilation (C:V) ratio on chest compression rate (CR), compression depth (CD), compression pressure (CP) and rescuer fatigue is unknown during pediatric CPR. We hypothesized that a 30:2 C:V ratio will decrease compression depth and compression pressure and increase rescuer fatigue compared with a 15:2 ratio. ⋯ During single rescuer pediatric BLS, more compression cycles were achieved with 30:2 C:V ratio without effect on compression depth, pressure and rate. Increased HR with 30:2 C:V ratio was noted during larger manikin CPR without subjective difference of reported fatigue. Most rescuers in AD and TF group did not achieve recommended compression depth regardless of C:V ratio.
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The prognostic implications of conversion to ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) patients with an initial non-shockable rhythm are unclear. ⋯ Based on a large-scaled population-based cohort of OHCA, subsequent VF with defibrillation was associated with better outcomes among patients with an initial non-shockable rhythm.
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Hyperkalemia may cause cardiac pacemaker (PMK) malfunctioning due to a reduction of the electronegativity of the resting myocardial potential. Both sensing and capture mechanisms could be temporarily affected, with possible life-threatening effects. ⋯ She was managed with immediate i.v. calcium chloride, followed by insulin/glucose and sodium bicarbonate infusions; the ECG recordings show an almost immediate correction of the PMK malfunctioning and serial improvement of the intraventricular conduction. This case supports the feasibility and effectiveness of i.v. calcium administration, as expected on the basis of electrophysiological ionized calcium effect on the threshold potential.