Resuscitation
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Comparative Study
Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: results from the Amsterdam resuscitation study (ARREST) in 'Utstein' style.
The purpose of this study was to describe the chain of survival in Amsterdam and its surroundings and to suggest areas for improvement. To ensure accurate data, collection was made by research personnel during the resuscitation, according to the Utstein recommendations. Between June 1, 1995 and August 1, 1997 all consecutive cardiac arrests were registered. ⋯ In 151 cases the police was also alerted and arrived 5 min (median) earlier than EMS personnel. Using the OPC/CPC good functional health was observed in 50% of the survivors and moderate performance in 29%. All links in the chain of survival must be strengthened, but equipping the police with semi-automatic defibrillators may be the most useful intervention to improve survival.
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We investigated survival of patients with out-of-hospital cardiac arrest in Ljubljana according to the 'Utstein' style. Ljubljana consists of urban, suburban and semi-rural communities which encompass an area of 1615 km2 with 397306 residents. The area is served by a single response emergency medical system and local family practitioners. ⋯ Collapse of non-cardiac etiology (117 patients) was preceded by either respiratory failure (41), politrauma (22), circulatory shock (19), cerebrovascular incident (ten), intoxication (nine), strangulation (seven), electrocution (five) or drowning (four patients). Only five patients (4.2%) survived to hospital discharge. Hospital treatment of patients after successful initial cardiopulmonary resuscitation was associated with high mortality and required considerable resources.
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This prospective study assesses the role of the hospital cardiac arrest team. We have determined who is responsible for return of spontaneous circulation in those patients who survive to discharge. A total of 83 adult patients were analysed over a 5 month period. ⋯ Two patients had circulation restored in the emergency department by the arrest team and none survived to discharge. All the survivors to hospital discharge had first responder return of spontaneous circulation. We suggest a revised role for the cardiac arrest team.
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Case Reports
When an AED meets an ICD... Automated external defibrillator. Implantable cardioverter defibrillator.
The chances of prehospital care providers being confronted with a patient with an implantable cardioverter defibrillator (ICD) are increasing and so care providers must receive proper training. Based on observations made during the resuscitation of a patient with an ICD using an automated external defibrillator (AED) some technical features and possible interactions of ICDs and AEDs are highlighted. Furthermore, we discuss the key points of basic knowledge, safety, and treatment protocols for cardiac arrest and other situations required for practical training in the ICD for prehospital care providers.