Resuscitation
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Clinical Trial
Impact of community-wide deployment of biphasic waveform automated external defibrillators on out-of-hospital cardiac arrest in Taipei.
To determine the impact and outcome of out-of-hospital cardiac arrests (OHCA) while using automated external defibrillators (AED) with biphasic waveforms and its effectiveness when using the Utstein Style community-wide in Taipei. ⋯ Low frequency of VF arrests is unique to certain eastern populations but without a reduction of AED shock efficacy with biphasic waveform. Besides initial VF and witnessed status, a prehospital post-shock organized rhythm irrespective of pulse appears to be correlated to survival. Certain circumstances in a congested metropolitan city consume time to deliver shocks even after EMS arrival, and might require bystander or public access defibrillation.
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Multicenter Study
Implementation of cardiopulmonary resuscitation guidelines in elderly care departments across: a survey of 13 hospitals shows wide variability in practice.
The United Kingdom Department of Health advises hospitals that they should implement a policy relating to cardiopulmonary resuscitation (CPR) that takes account of published guidelines relating to decision making for resuscitation. We wished to see if these guidelines were leading to implementation of a similar policy in different Elderly Care (EC) departments. ⋯ Implementation of the guidelines for decision making for resuscitation varies greatly across this region of the United Kingdom.
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No valid model has been developed to predict survival following out-of-hospital cardiac arrest. The purpose of this study was to develop a prediction model for meaningful survival following out-of-hospital cardiac arrest using variables available during resuscitation. ⋯ This study reports decision rules for potential meaningful survival following out-of-hospital cardiac arrest with high NPVs for each. Future studies need to be performed to prospectively validate these models.
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Comparative Study
Uninterrupted chest compression CPR is easier to perform and remember than standard CPR.
It has long been observed that CPR skills rapidly decline regardless of the modality used for teaching or criteria used for testing. Uninterrupted chest compression CPR (UCC-CPR) is a proposed alternative to standard single rescuer CPR (STD-CPR) for laypersons in witnessed unexpected cardiac arrest in adults. It delivers substantially more compressions per minute and may be easier to remember and perform than standard CPR. ⋯ Chest compression performance during STD-CPR declined in repeated testing over 18 months whereas there was minimal decline in chest compressions performance on repeated testing of UCC-CPR. In addition, substantially more chest compressions were delivered during UCC-CPR compared to STD-CPR at all time points primarily because of long pauses accompanying rescue breathing.
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Favorable neurological survival in out-of-hospital cardiac arrest (OOHCA) may be influenced by cerebral perfusion during resuscitation. Cerebral oximetry (COx) provides a portable, noninvasive, real-time index of cerebral perfusion that has not been studied in OOHCA. This study examined the feasibility of using COx to measure cerebral perfusion during OOHCA. ⋯ In our sample of OOHCA patients, cerebral perfusion is rarely detectable using an oximeter during CPR. Ventilation rate does not alter the oximeter readings. It is possible that the current standard mechanical method of cardiopulmonary resuscitation provides little or no cerebral oxygenation during OOHCA.