Resuscitation
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Few prospective studies of the incidence and outcome of paediatric in-hospital cardiopulmonary arrest have been reported to enable quality assurance comparisons within and between institutions. ⋯ In-patient paediatric cardiac arrest has a mediocre outcome with a better outlook if the initial rhythm is hypotensive-bradycardia, VF or pulsatile VT. Doses of adrenaline greater than 15 mcg/kg given for non-shockable rhythms may cause secondary VF which has a worse outcome than primary VF.
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Multicenter Study Comparative Study Clinical Trial
Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study.
To compare quality of CPR during out-of-hospital cardiac arrest with and without automated feedback. ⋯ Automatic feedback improved CPR quality in this prospective non-randomised study of out-of-hospital cardiac arrest. Increased compression depth was associated with increased short-term survival.
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Randomized Controlled Trial Comparative Study
Online resuscitation training. Does it improve high school students' ability to perform cardiopulmonary resuscitation in a simulated environment?
There are no published data on the efficacy of online first aid or resuscitation learning programmes in Australia. Our goal was to compare the knowledge and first aid skills of subjects who have undertaken the St. John Ambulance Australia (WA) "online crash course", with those who have no first aid training. ⋯ There were significant differences in the performance of the written test, between the group who completed the course and the group who did not complete the course (P = 0.036: Mann-Whitney U-test). There were no significant differences in the performance of any other practical tasks between the two groups. We conclude from this that the online course improved course participant's knowledge of BLS significantly, but not their ability to perform; that online first aid courses may be useful for knowledge acquisition but that they do not confer any benefit, in performance of BLS skills.
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An intrathoracic pressure regulator (ITPR) is a device that can be added to the external end of a tracheal tube to create controlled negative airway pressure between positive pressure ventilations. The resulting downward bias of the airway pressure baseline promotes increased venous return and enhanced circulation during CPR and also during hypovolemic shock. ⋯ Thereafter perfusion pressure plateaus. Negative bias pressures exceeding -10 cm H2O are not needed in ITPR-CPR.
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Randomized Controlled Trial Multicenter Study
Quality of lay person CPR performance with compression: ventilation ratios 15:2, 30:2 or continuous chest compressions without ventilations on manikins.
The new CPR guidelines emphasise chest compression depth and have increased the compression:ventilation ratio to cause less time intervals without chest compressions. How this change may influence the quality of chest compressions is not documented. Sixty-eight volunteers among travellers at Oslo international airport and a senior citizen centre performed 5 min of CPR on a manikin with compression:ventilation ratios 15:2, 30:2 or continuous chest compressions. ⋯ Number of compressions per minute was 40 +/- 9, 43 +/- 14 and 73 +/- 24 and percent no flow time 49 +/- 13%, 38 +/- 20% and 1 +/- 2%, respectively. In conclusion, continuous chest compressions without ventilations gave significantly more chest compressions per minute, but with decreased compression quality. No flow time for 30:2 was significantly less than for 15:2.