Resuscitation
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Comparative Study
Improved hemodynamic performance with a novel chest compression device during treatment of in-hospital cardiac arrest.
The purpose of this pilot clinical study was to determine if a novel chest compression device would improve hemodynamics when compared to manual chest compression during cardiopulmonary resuscitation (CPR) in humans. The device is an automated self-adjusting electromechanical chest compressor based on AutoPulse technology (Revivant Corporation) that uses a load distributing compression band (A-CPR) to compress the anterior chest. ⋯ Previous research has shown that increased CPP is correlated to increased coronary blood flow and increased rates of restored native circulation from sudden cardiac arrest. The A-CPR system using AutoPulse technology demonstrated increased coronary perfusion pressure over manual chest compression during CPR in this terminally ill patient population.
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The bystander is often the first person present at the scene of an accident. Our aim was to determine how often and how well bystanders perform trauma care and whether trauma care is affected by the bystander's level of training, relationship to the patient and numbers of bystanders present. ⋯ Improved, more widespread training could increase the frequency and quality of bystander trauma care further.
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The purpose of this study was to evaluate the outcome of out-of-hospital cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in the city of Katowice, Poland, during a period of 1 year prior to the planned reorganization of the national emergency system. Data were collected prospectively according to a modified Utstein style. To ensure accurate data collection, a special method of reporting resuscitation events with the use of a tape-recorder was introduced. ⋯ Most of these patients had a good neurological outcome. Time to first defibrillatory shock was significantly shorter for survivors (median 7 min) compared to non-survivors (median 10 min). The most important resuscitation and patient characteristics associated with survival were VF as initial rhythm, arrest witnessed, and lay-bystander CPR.
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This study was planned to record prehospital death rates in four medical priority categories (A, B, C and D) and to evaluate if deaths in lower urgency categories C and D (target response times 20 and 90 min) could have been avoided by a faster ambulance response. ⋯ The use of medical priority dispatching was associated with very low prehospital mortality in lower urgency categories C and D. Approximately, one-third of those deaths could probably be prevented by a faster ambulance response but the price would be a three-fold increase in calls with blue lights and siren. Further studies are needed to find out if our results are applicable to other types of EMS systems.