Resuscitation
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To examine whether "all-or-none" guidelines for cardiopulmonary resuscitation (CPR) are being applied by practitioners on general medical wards (GMWs). ⋯ (1) DNAR orders are rarely discussed with patients and their next of kin in GMWs within the region examined; (2) even when DNAR is discussed, physicians tend to confer DNAR orders based on their personal value judgements rather than on patient preferences; (3) practitioners on GMWs perform CPR when no pathophysiological benefit is expected; (4) limited resuscitation efforts are performed frequently in GMWs.
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Biography Historical Article
Resuscitation greats. Ambroise Paré and the arrest of haemorrhage.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Measuring survival rates from sudden cardiac arrest: the elusive definition.
Measuring survival from sudden out-of-hospital cardiac arrest (OOH-CA) is often used as a benchmark of the quality of a community's emergency medical service (EMS) system. The definition of OOH-CA survival rates depends both upon the numerator (surviving cases) and the denominator (all cases). ⋯ Reported OOH-CA rates and survival rates vary widely, depending upon the definitions applied to events. Rigorous assessment of treatments applied to improve survival can be obscured by inappropriate definitions. Large-scale randomized interventions designed to improve survival from OOH-CA can be evaluated based upon the absolute numbers of patients surviving, rather than a change in the proportion surviving.
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To determine if attendance at a Resuscitation Council (UK) immediate life support (ILS) course influenced the skill deployment of nurses at a subsequent cardiac arrests. ⋯ ILS training alone may be insufficient to increase deployment of these skills by nurses who are not cardiac arrest team members. A more supportive approach, involving individual coaching of these individuals may need to be considered.
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We assessed the familiarity of the general public with automated external defibrillators (AEDs) and their willingness to use them. ⋯ Although a substantial number of people in this setting were willing to use an AED, education regarding legal liability and proper use of the machines increased the reported likelihood of use. Further public education may be necessary to provide optimally effective public access defibrillation programs.