Resuscitation
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Comparative Study
Influence of early defibrillation on the survival rate and quality of life after CPR in prehospital emergency medical service in a German metropolitan area.
Early defibrillation by emergency medical personnel has been shown to improve survival in patients suffering from out-of-hospital cardiac arrest with ventricular fibrillation. Due to organisational differences it is difficult to compare results in various studies. Comparison of studies has been simplified by introduction of the Utstein template. ⋯ Twelve patients in G1 and 16 in G2 were discharged from hospital. The survival rate was similar in both groups (after 6 months G1: n=12; G2: n=14, after 12 months G1: n=10; G2: n=13 and after 24 months G1: n=9; G2: n=10), and the quality of life according to Glasgow-Pittsburgh Cerebral Performance Category (CPC) and Overall Performance Category (OPC) scores also was comparable between groups. We conclude that early defibrillation provides a higher incidence of return of a spontaneous circulation, a reduced need for antiarrhythmics and shorter in-hospital treatment times in patients with out-of-hospital ventricular fibrillation.
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To describe survival after in-hospital cardiac arrest in relation to the interval between collapse and start of cardiopulmonary resuscitation (CPR). ⋯ Among patients with in-hospital cardiac arrest in whom the interval between collapse and start of CPR was known, we found that in 80% of the cases CPR was started within the first minute after collapse. Among these patients, survival to discharge was twice that of patients in whom CPR was started later. These results highlight the importance of immediate CPR after in-hospital cardiac arrest.
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Comparative Study
Evaluation of a new method for the carotid pulse check in cardiopulmonary resuscitation.
The ability to determine the presence or absence of a central pulse remains a key skill in cardiopulmonary resuscitation (CPR) for healthcare providers, despite studies showing that they perform this poorly. The aim of this study was to evaluate a modified technique for palpation of the carotid pulse. ⋯ The new method of carotid pulse palpation results in a more rapid determination of the carotid pulse when it is present in all positions except with the neck neutral on the floor. This will only be clinically significant if trauma is suspected.
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As part of a continuous quality assurance process which we instituted in 1999, we review videotapes of selected high-risk deliveries at our hospital. We utilized our reviews to evaluate the occurrence of errors, and to evaluate team and leader functions during neonatal resuscitation. ⋯ We believe that neonatal resuscitation may be improved by the provision of teaching about team and leader functions, encouraging debriefing following complicated resuscitations, developing a minimal form to be completed for any patient requiring compressions or epinephrine within the delivery room, and providing more direct observations regarding the actual conduct of resuscitation.
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To study whether two different types of monophasic waveform shocks (i.e. monophasic damped sinusoidal [MDS] and monophasic truncated exponential [MTE] waveform shocks) are of equivalent efficacy. ⋯ Our data suggest disparity in efficacy between MDS waveform shocks and MTE waveform shocks. Furthermore, our findings should be taken into consideration when the issue of the control group(s) in future clinical trials on new waveforms is discussed.