Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Determination of heart rate in the baby at birth.
The International Liaison Committee on Resuscitation (ILCOR) publishes guidelines on neonatal resuscitation, which are evidence-based where possible. Initial assessment of heart rate, breathing and colour is an essential part of newborn resuscitation and the guidelines state that heart rate may be assessed using a stethoscope, or palpating the umbilical, brachial or femoral pulse. This study aimed to assess the most effective method(s) of heart rate assessment in the newborn baby. ⋯ Umbilical pulsations must not be relied upon if low or absent. In assessing heart rate in newborn resuscitation only the stethoscope is likely to be completely reliable. In the absence of a stethoscope only the umbilical pulse should be used with an awareness of its limitations.
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Comparative Study
Non-traumatic aortic dissection or rupture as cause of cardiac arrest: presentation and outcome.
To evaluate the frequency, presentation and outcome of non-traumatic aortic dissection/rupture as a cause of cardiac arrest. ⋯ Cardiac arrest caused by aortic dissection/rupture is rare, and mortality remains very high, even when circulation can be restored initially. Common features such as previously known aortic aneurysm, old age, male gender and pulseless electrical activity as initial cardiac rhythm should increase suspicion of the condition.
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Randomized Controlled Trial Comparative Study Clinical Trial
Biphasic concentration change during continuous midazolam administration in brain-injured patients undergoing therapeutic moderate hypothermia.
To define the pharmacokinetics of midazolam, a probe for monitoring cytochrome (CYP) 3A 4 activity, during moderate hypothermic therapy. ⋯ This study has demonstrated for the first time that midazolum concentration changes biphasically even during continuous infusion in hypothermic therapy. The mechanisms for the change are unclear. Thus, further studies including confirmation of cytochrome 3A 4 activity are required, while monitoring for the development of undesirable effects from over-dosing is also needed.
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Comparative Study
Long-term subjective memory function in ventricular fibrillation out-of-hospital cardiac arrest survivors resuscitated by early defibrillation.
Brain injury after a cardiac arrest remains a major cause of morbidity. Programs focusing on early defibrillation have yielded improved survival of patients after hospital discharge following ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Early defibrillation that promptly restores a circulating rhythm should decrease the hypoxic period and subsequent organ injury. Therefore this study was designed to determine if long-term memory complaints persist in VF OHCA survivors resuscitated in an early defibrillation program when compared with a healthy control population not experiencing cardiac arrest. ⋯ In a cohort of VF OHCA patients, survivors report more memory complaints in comparison with a general healthy older population. There were more long-term-memory complaints in younger patients. Patients with higher long-term quality-of-life score have fewer memory complaints.
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Comparative Study
What do we know about patients dying in the emergency department?
To determine our knowledge in terms of cause of death and quality of death certification about patients who die in the emergency department. To establish the role of autopsy in this matter. ⋯ Autopsy remains a very important tool to establish the cause of death in patients dying in ED. The concordance between the antemortem presumed cause of death recorded in the patient notes and the real cause (all patient data) is poor.