Resuscitation
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Practice Guideline
Recommended guidelines for reviewing, reporting, and conducting research on post-resuscitation care: the Utstein style.
The aim of this report is to establish recommendations for reviewing, reporting, and conducting research during the post-resuscitation period in hospital. It defines data that are needed for research and more specialised registries and therefore supplements the recently updated Utstein template for resuscitation registries. The updated Utstein template and the out-of-hospital "Chain of Survival" describe factors of importance for successful resuscitation up until return of spontaneous circulation (ROSC). ⋯ Suggested data are defined as core and supplementary and include the following categories: pre-arrest co-morbidity and functional status, cause of death, patients' quality of life, in-hospital system factors, investigations and treatment, and physiological data at various time points during the first three days after admission. It is hoped that the publication of these recommendations will encourage research into the in-hospital post-resuscitation phase, which we propose should be included in the chain-of-survival as a fifth ring. Following these recommendations should enable better understanding of the impact of different in-hospital treatment strategies on outcome.
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During recent years, in-hospital cardiopulmonary resuscitation (CPR) management has received much attention. However, the rate of survival after in-hospital resuscitation in Iran hospitals is not known. Therefore, a study was designed to evaluate the outcome of in-hospital cardiopulmonary resuscitation (CPR) in the city of Kashan, Iran, during a 6-month period during 2002. ⋯ Our study showed that it needs more attention to be paid to cardiopulmonary resuscitation management in Iran's hospitals. The results of this study could be an important first step toward a national study on the survival after cardiopulmonary resuscitation to provide accurate data on our performance with regards to the chain of survival.
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Cardiac arrest induces severe mesenteric ischaemia. The objective of this study was to assess the frequency of gut dysfunction and endoscopic lesions following resuscitation after cardiac arrest, and to evaluate the potential value of gut endoscopy performance in these circumstances. ⋯ The frequent occurrence of endoscopic lesions in the presence of gut dysfunction following a cardiac arrest could suggest systematic gut endoscopy in such patients. However, an alternative recommendation would be to watch these patients very closely, treat all with prophylactic proton pump inhibitors, and endoscope only those with evidence of bleeding.
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In the Austrian emergency medical service (EMS), emergency medical technician-staffed and physician-staffed vehicles are in operation. Patients with suspected acute coronary syndromes (ACS) are treated in the pre-hospital phase and transported to the hospital by an emergency physician (EP). This study evaluates the diagnostic performance of EPs in ACS and the impact of this emergency system on the outcome of ACS in an urban area. ⋯ The percentage of ACS patients transported to hospital by an EP is very low, and EPs seem to be "over-aware" in the diagnosis of ACS.
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An impedance threshold valve (ITV) is a new airway adjunct for resuscitation that permits generation of a small vacuum in the chest during the recoil phase of chest compression. ⋯ An ITV can augment perfusion during CPR. The observed effectiveness of ITVs in the laboratory and in the clinic suggests a thoracic pump mechanism for Standard CPR, and perhaps also an effective compression threshold that must be exceeded to generate blood flow by external chest compression.