Resuscitation
-
Randomized Controlled Trial
Accuracy of clinical assessment of infant heart rate in the delivery room.
Heart rate (HR) dictates intervention during neonatal resuscitation. Guidelines recommend that HR be assessed by auscultation or palpation. ⋯ Clinical assessment by 23 observers randomly allocated to assess HR by one of two methods in 26 infants, was found to be inaccurate and underestimate ECG HR. The mean difference between HR assessed by auscultation and palpation ECG and HR using methodology recommended by the Neonatal Resuscitation Programme was 14 and 22 beats per minute respectively.
-
Comparative Study
Discussing and documenting (do not attempt) resuscitation orders in a Dutch Hospital: a disappointing reality.
To determine whether the introduction of a patient information sheet about do not attempt resuscitation (DNAR) orders and personal motivation of the medical staff results in an improvement in the documentation of the DNAR orders in the medical records. ⋯ Giving patients more information about DNAR orders and motivating medical staff personally does not influence the documentation of DNAR orders. If documented, it occurred more in the elderly and the deceased patients. Only a few DNAR orders were specified and most were initiated by the doctor.
-
Comparative Study
Clinical testing of cellular phone ringing interference with automated external defibrillators.
This study examined cellular phone ringing interference with automated external defibrillators (AED). ⋯ Clinical testing during ECG monitoring by an AED during call from a cellular phone did not show any analysis dysfunction during unshockable rhythms and provoked only transient dysfunction of the speaker device.
-
The recommended depth for chest compression during adult cardiopulmonary resuscitation (CPR) is 4-5 cm, and for children one-third the anterior-posterior (AP) chest diameter. A compression depth of one-third of the AP chest diameter has also been suggested for adult CPR. We have assessed chest CT scans to measure what proportion of the adult AP chest diameter is compressed during CPR. ⋯ The commonest anatomical structures that would be compressed are the ascending aorta (38%) and the top of the left atrium (36%). There is also a wide anatomical variation in the shape of the adult chest. A chest compression depth of 4-5 cm in adults equates to approximately one-fifth of the AP diameter of the adult chest.
-
A non-linear mathematical model of the oesophagus was developed to study the effects of non-invasive ventilation variables on the severity of gastric inflation. The model was based on the non-linear physical characteristics of biological tissue. The model simulated oesophageal mechanical function during non-invasive ventilation in cardiac arrest (2:30 ventilations/chest compressions cycles) and respiratory arrest (1:5 ventilations/s) as recommended by the European Resuscitation Council (ERC) in its 2005 guidelines for adult basic and advanced life support. ⋯ The model indicates that the time required for the air trapped in the oesophagus to completely deflate is approximately 2 s. This may be longer than the expiratory time recommended by the 2005 guidelines. Model predictions support the 2005 guidelines regarding the decrease in the tidal volume and in the inspiratory pressure in an effort to minimise gastric inflation.