Resuscitation
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Randomized Controlled Trial
The effects of changes to the ERC resuscitation guidelines on no flow time and cardiopulmonary resuscitation quality: a randomised controlled study on manikins.
The European Resuscitation Council (ERC) guidelines changed in 2005. We investigated the impact of these changes on no flow time and on the quality of cardiopulmonary resuscitation (CPR). ⋯ The use of a single shock sequence with guidelines 2005 has decreased the no flow time during CPR when compared with guidelines 2000 with multiple shocks.
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The present study examined the ability of the crew of small fast rescue boats to perform basic life support (BLS) at sea. Tests were undertaken aboard a 67m emergency response and rescue vessel (ERRV), a 9.1m (30ft) and 11.6m (38ft) fast rescue craft ("daughter craft" (DC)). It was hypothesised that the ability to perform BLS on a DC would be significantly impaired when compared with that seen on the ERRV. ⋯ It is concluded that the performance of BLS on small boats, in particular rescue breathing, is significantly adversely affected by two major factors, motion-induced interruption and early fatigue. As a consequence, the likelihood of conducting fully effective continuous BLS on a small boat in a seaway for any length of time, with a good chance of a successful outcome, is considered to be poor. However, this should not deter rescuers from attempting to make such efforts where practicable.
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To develop a clinically relevant experimental model of cardiac arrest and CPR in which a partial occlusion of the left anterior descending coronary artery (LAD) is maintained during the resuscitation procedure and the initial post-resuscitation interval. ⋯ In this model of prolonged untreated cardiac arrest, maintaining a partial occlusion of the LAD during CPR and the initial post-resuscitation interval required a greater number of shocks before ROSC, increased severity of post-resuscitation myocardial dysfunction significantly and yielded less favourable outcomes.
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Comparative Study
Comparison of termination-of-resuscitation guidelines for out-of-hospital cardiac arrest in Singapore EMS.
Termination of resuscitation (TOR) in the field for out-of-hospital cardiac arrest (OHCA) can reduce unnecessary transport to hospital and increase availability of resources for other patients. ⋯ We found all three TOR guidelines to have high sensitivity and negative predictive value. However the specificity and transport rates varied greatly. Application of any TOR guidelines may be affected by local EMS and population factors which should be considered in any policy decision.
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Comparative Study
Efficacy of therapeutic hypothermia after out-of-hospital cardiac arrest due to ventricular fibrillation.
We investigated implementation and efficacy of mild therapeutic hypothermia in the treatment of out-of-hospital cardiac arrest due to ventricular fibrillation. ⋯ Therapeutic hypothermia is efficient in significantly improving survival and neurological outcome of out-of-hospital cardiac arrest with ventricular fibrillation. By using a simple method, it can be implemented easily and quickly, without side effects.