Resuscitation
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Prehospital termination of resuscitation rules are used to decide on one of two actions: to continue resuscitation and transport to hospital or to terminate resuscitation. The literature is confusing as some rules are derived with survival as the outcome of interest (predicting when to transport and reporting sensitivity and negative predictive value) and other rules use death (predicting when to terminate resuscitation and reporting specificity and positive predictive value). Very few publish the EMS transport rate when the rule is applied; the outcome of interest to EMS services. ⋯ We suggest that the diagnostic test characteristics of termination of resuscitation rules should be reported with death as the primary outcome which identifies for the paramedics futile resuscitations that should be terminated in the field. We also emphasize the need to report transport rates to provide the EMS services with an implementation benchmark.
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Immediate bystander cardiopulmonary resuscitation (CPR) is the most essential factor for life saving in out-of-hospital cardiac arrest patients. We investigated the characteristics associated with willingness to attempt CPR among the Japanese general population. ⋯ Experience of CPR training closely associated with willingness to attempt CPR, and awareness of AED in a public space are significant factors in CPR training. AED placement might call attention to CPR training and develops willingness to attempt CPR.
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There is a need to measure cardiopulmonary resuscitation (CPR) in order to document whether ambulance personnel follow CPR guidelines. Our goal was to do this using defibrillator technology based on changes in transthoracic impedance (TTI) produced by chest compressions and ventilations. ⋯ Core CPR values can be measured from TTI signals by using a standard defibrillator and new software. NFR was 25% (20% adjusted) with great rescuer variability.
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The American Heart Association 2005 Guidelines recommend immediate defibrillation for ventricular fibrillation (VF) of short duration, such as witnessed sudden cardiac arrest. However, it is unclear if public-access automated external defibrillators (AEDs) would actually be used in Japan, because there have been few studies about public attitudes regarding AED use. Therefore, we examined Japanese attitudes toward AED use. ⋯ Many non-medical people in Japan would be unwilling to operate an AED, because they do not know what AED is and/or how to use an AED. However, many would be willing to operate AEDs if they had better understanding of AEDs. Thus, it is necessary to improve public knowledge of AEDs and AED use.
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Assessing the neurological and disability status of cardiac arrest (CA) survivors is important for evaluating the outcomes of resuscitation interventions. The Cerebral Performance Category (CPC)--the standard outcome measurement after CA--has been criticized for its poorly defined, subjective criteria, lack of information regarding its psychometric properties, and poor relationships with long-term measures of disability and quality of life (QOL). This study examined the relationships among the CPC and measures of global disability and QOL at discharge from the hospital and at 1 month after CA. ⋯ When compared to disability and quality of life measures, it is apparent that the CPC has limited ability to discriminate between mild and moderate brain injury. The validity of using the chart review method for obtaining scores is questionable.