Resuscitation
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Comparative Study
Body surface mapping versus the standard 12 lead ECG in the detection of myocardial infarction amongst emergency department patients: a Bayesian approach.
To determine if body surface mapping (BSM) is better than the standard 12 lead ECG in the diagnosis of acute myocardial infarction amongst emergency department patients. ⋯ BSM has a higher sensitivity, but a lower specificity for the diagnosis of myocardial infarction.
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To determine the error of measurement in pulse oximetry with a decreased arterial perfusion and to identify a systolic pressure threshold for (1) initial detection and (2) a reliable reading of oxygen saturation. ⋯ Pulse oximetry is reliable with a systolic blood pressure > 80 mmHg. The lower the BP, the lower the pulse oximetry readings leading to a bias of up to -45%.
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Measuring different intervals during cardiopulmonary resuscitation is a key element of resuscitation performance. For accurate time measurements, the internal clocks of automated external defibrillator (AEDs) need to be synchronized with the dispatch centre time. ⋯ Synchronisation of AED clocks is not widespread in Finland. Instructions to synchronize have been issued in a minority of EMS systems. Despite this, time deviations are large, and erroneous times are recorded.
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Mild therapeutic hypothermia has shown to improve neurological outcome after cardiac arrest. Our study investigated the efficacy and safety of cold simple intravenous infusions for induction of hypothermia after cardiac arrest preceding further cooling and maintenance of hypothermia by specialised endovascular cooling. ⋯ Our results indicate that induction of mild hypothermia with infusion of cold fluids preceding endovascular cooling is safe and effective.
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Recent data suggest that generation of negative intrathoracic pressure during the decompression phase of CPR improves hemodynamics, organ perfusion and survival. ⋯ Incomplete chest wall recoil during the decompression phase of CPR increases endotracheal pressure, impedes venous return and decreases mean arterial pressure, and coronary and cerebral perfusion pressures.