Resuscitation
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To assess the relative importance of multiple organ failure (MOF) and cerebral damage on the mortality rate following trauma we analyzed retrospectively the records from 99 polytrauma patients admitted to a multidisciplinary European intensive care unit in a 2 year period. In all, 93% of the trauma was non-penetrating and 73% was the result of road accidents. 28 patients died giving an overall mortality of 28.3%. ⋯ A total of six deaths occurred after 24 h, four due to extensive cerebral lesions, one due to hemorrhagic shock and one due to multiple organ failure. In our experience, cerebral damage was a more common cause of death than MOF following multiple non-penetrating trauma.
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This paper presents the second part of the validated Cardiff test for one rescuer basic life support skills, based on observation of video recording combined with the Recording Resusci Anne printout (VIDRAP). The authors believe that this is a robust evaluation tool which is capable of assessing the potential value to a casualty of a simulated resuscitation. The adoption of a widely accepted test methodology would facilitate comparison of research in different centres, which is not possible at present.
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Brainstem auditory evoked responses (BAER) are routinely used to monitor brainstem function in hospitalized comatose patients. We used a rat model of cardiac arrest and resuscitation to explore the possibility that the BAER, monitored during and immediately after cardiopulmonary resuscitation (CPR), could be used to determine whether the CPR was effective in restoring brainstem blood flow. Long-Evans rats were subjected to 7 min of cardiac arrest, induced by chest compression under Ketamine anesthesia sufficient to mechanically prevent the heart from pumping blood and were then resuscitated using a standard CPR protocol. ⋯ If it was greater than 0.35 ms the rat died. This signal was used as a cue for intervention in three rats; two survived. Thus, in this preparation, the BAER provided a useful measure of CPR effectiveness, in time to permit successful intervention.
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The aim of the study was to evaluate whether mass-mailing of a 12-month wall calendar which focused on child and infant safety and first aid treatment had any educational effect on lay people. The calendar included algorithms for removal of a foreign body from the airways and infant and child CPR. The knowledge and skills in these procedures were tested in two groups using a previously validated check-list before and after the introduction of the calendar. ⋯ Whether the test persons had children 0-8 years old or not, did not affect the results. In conclusion the calendar had no educational effect when distributed by mail, but a safety campaign which included distribution of the calendar and a possibility to borrow a manikin had a positive influence on the first aid skills and knowledge of lay people. Mass mailing of CPR or other first aid material free-of-charge does not seem to further the goal of increasing the rate and proficiency of bystander interventions to save lives.
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The voluntary Swedish Cardiac Arrest Registry has collected and analyzed 14,065 standardised reports on cardiac arrests up until May 1995. The reports have been collected from approximately half of Sweden's ambulance districts, which cover 60% of the population. Resuscitation was attempted in 10,966 cases. ⋯ Survival to 1 month in the subgroup which presented with VT/VF was 9.5%. We found no significant difference between survival in large cities and smaller communities. The survivors were analysed in relation to time to defibrillation and we found a strong correlation between a short time and increased survival.