Resuscitation
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The aim of our study was to evaluate the effect of an automated external defibrillation (AED) training programme on the knowledge, attitudes and application of BLS and AED use in young people of secondary school age in Manchester, United Kingdom. ⋯ This study demonstrates that training through the ORCS scheme has a positive influence on the ability of secondary school teenagers to perform emergency life support (ELS), but particularly in their ability to deploy an AED and perform CPR.
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To evaluate the outcome and quality of in-hospital cardiopulmonary resuscitation (CPR), and factors affecting the outcome. ⋯ In our setting, survival to discharge is 6.9%. Initial survival rate was strongly associated with being in a monitored area. Defibrillators and the critical care areas were insufficient.
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To study the reliability and validity of a scoring instrument for the assessment of neonatal resuscitation skills in a training setting. ⋯ A useful and valid instrument with good intra-rater and reasonable inter-rater reliability is now available for the assessment of neonatal resuscitation skills in a training setting. Its reliability can be improved by using a more advanced manikin and by training of the raters.
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There is growing evidence that microcirculatory blood flow is the ultimate determinant of the outcome in circulatory shock states. We therefore examined changes in the microcirculation accompanying the most severe form of circulatory failure, namely cardiac arrest and the effects of subsequent cardiopulmonary resuscitation. Ventricular fibrillation was electrically induced in nine pigs and untreated for 5min prior to beginning closed chest cardiac compression and attempting electrical defibrillation. ⋯ In animals that were successfully resuscitated, microvascular flow was significantly greater after 1 and 5min of chest compression than in animals with failed resuscitation attempts. Microvascular blood flow was highly correlated with coronary perfusion pressure (r=0.82, p<0.01). Microvascular blood flow in the sublingual mucosa is therefore closely related to coronary perfusion pressure during cardiopulmonary resuscitation and both are predictive of outcome.
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Comparative Study
In-hospital cardiac arrest: is outcome related to the time of arrest?
Whether outcome from in-hospital cardiopulmonary resuscitation (CPR) is poorer when it occurs during the night remains controversial. This study examined the relationship between CPR during the various hospital shifts and survival to discharge. ⋯ Although unwitnessed arrest is more prevalent during night shift, resuscitation during this shift is associated with poorer outcomes independently of witnessed status. Further research is required into the causes for the increased mortality observed after night shift resuscitation.