Resuscitation
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Comparative Study
Characteristics and outcome among patients suffering from in hospital cardiac arrest in relation to whether the arrest took place during office hours.
To describe the characteristics and outcome among patients suffering from in hospital cardiac arrest in relation to whether the arrest took place during office hours. ⋯ Among patients suffering from in hospital cardiac arrest and in whom CPR was attempted those who had the arrest during office hours had a survival rate being more than twice that of patients who had the arrest during other times of the day and night. These results indicate that the preparedness for optimal treatment of in hospital cardiac arrest is of ultimate importance for the final outcome and that an increased preparedness during evenings and nights might increase survival among patients suffering from in hospital cardiac arrest.
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Surf lifesavers in Australia undertake numerous resuscitation scenarios in the course of their training and examination. The standard teaching and examination strategy is for the scenario to end with return of spontaneous circulation (ROSC) and then breathing. This study was performed to assess the effect of this training technique on lifesavers' expectation of successful resuscitation and to determine the effect of experience on these expectations. ⋯ Surf lifesavers in the Sydney Northern Beaches branch have an exaggerated expectation of the chances of successful CPR following cardiac arrest. This expectation did not change with time since learning CPR or participation in actual resuscitations. New models for CPR education need to be investigated.
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Comparative Study
Endotracheal drug administration during out-of-hospital resuscitation: where are the survivors?
Drugs administered endotracheally are effectively absorbed during normal spontaneous cardiac activity. However, animal cardiac arrest studies and limited clinical investigations do not support either the use of endotracheal (ET) drugs in doses currently recommended for adults or the method of direct endotracheal instillation. The purpose of this study was to compare the effect of intravenous (IV) and ET drug therapy on outcome from out-of-hospital cardiac arrest secondary to all cardiac arrest rhythms. ⋯ For our out-of-hospital advanced rescuer system, ET drugs at recommended doses (twice the IV dose) injected into an ET tube during cardiac arrest and CPR were of no benefit.
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To ascertain important factors in the improvement of out-of-hospital cardiac arrest survival rates through analysis of data for Osaka Prefecture with the focus on time factors. ⋯ This study using the standardized format according to the Utstein style clearly elucidates the specific delay of the start of defibrillation by paramedics and also indicates the inappropriate rule for this procedure in Japan.
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Anaphylactoid reactions to iodinated contrast media can cause life-threatening events and even death. A 44-year-old woman presented with cardiopulmonary arrest (CPA) immediately following the administration of nonionic iodinated contrast media for an intravenous pyelography. Her cardiac rhythm during CPA was asystole. ⋯ The patient did not have a history of allergy, but had experienced a myocardial infarction and aortitis. She had undergone 11 angiographies and had been taking a beta-adrenergic receptor antagonist. Planned emergency medical backup is advisable to ensure resuscitation in the event of an anaphylactoid reaction to the use of contrast media in-hospital settings.