Resuscitation
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Controlled Clinical Trial
To see or not to see--better dispatcher-assisted CPR with video-calls? A qualitative study based on simulated trials.
Video communication through mobile telephone is now available in many parts of the world. We ask how mobile phone video-calls compares with traditional phone calls for dispatcher-assisted cardiopulmonary resuscitation (T-CPR). ⋯ Video communication can improve the dispatchers' understanding of the rescuer's situation, and the assistance they provide.
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Comparative Study
Shock outcome prediction before and after CPR: a comparative study of manual and automated active compression-decompression CPR.
We report on a study designed to compare the relative efficacy of manual CPR (M-CPR) and automated mechanical CPR (ACD-CPR) provided by an active compression-decompression (ACD) device. The ECG signals of out-of-hospital cardiac arrest patients of cardiac aetiology were analysed just prior to, and immediately after, cardiopulmonary resuscitation (CPR) to assess the likelihood of successful defibrillation at these time points. The cardioversion outcome prediction (COP) measure previously developed by our group was used to quantify the probability of return of spontaneous circulation (ROSC) after counter-shock and was used as a measure of the efficacy of CPR. ⋯ However, a detailed statistical analysis carried out between the groups adjusted for pre-CPR value showed no significant difference between the two methods of CPR (p=0.20). Similarly, adjusting for length of CPR showed no significant difference between the groups. Secondary, subgroup analysis of the ECG according to the length of time for which CPR was performed showed that both types of CPR led to an increase in the likelihood of successful defibrillation after increasing durations of CPR, however results were less reliable after longer periods of continuous CPR.
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We investigated the effect of electroconvulsive stimulation (ECS) on cerebral circulation in vivo using the method for measuring microcirculation in real time with the photosensitizer dye Photosense and the fiber optic spectrofluorometer LESA-01-BIOSPEC. We have found that electroconvulsive stimulation significantly improved cerebral microcirculation (fourfold higher comparing to the control cerebral perfusion) after 30 min of room-temperature cardiac arrest. Morphologic study of the brain tissue showed the absence of rouleaux formation of erythrocytes ("sludged blood") in the cerebral cortex microcirculation after the application of electrical stimulus. Electroconvulsive stimulation may be useful for improving cerebral microcirculation (blood flow) in cases of long-term brain hypoxia/anoxia after prolonged cardiac arrest.
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To examine the current status and problems of resuscitation management in Japan as demonstrated at the 2006 and 2007 Osaka Senri medical rallies. ⋯ Significant differences in performance between the AHA and ERC methods were observed. The ERC guidelines were more rational and suitable in terms of actual application than the AHA guidelines.
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We reassessed 1-month survival of patients with witnessed out-of-hospital cardiac arrest (OHCA) of cardiac origin with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) in Osaka, Japan, and identified factors associated with 1-month survival using updated data from 1998 to 2004 collected based on the Utstein Style. ⋯ We successfully developed a model to estimate the probability of 1-month survival using variables easy to collect in the early phase of resuscitation, and this model would help physicians and family members predict the likelihood of 1-month survival of OHCA patients on admission.