Resuscitation
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To summarise in a systematic review the effectiveness of interventions to treat foreign body airway obstructions (FBAO). ⋯ Key interventions successfully relieve FBAO, but may be associated with important harms. Guidelines for FBAO management should balance the benefits and harms of interventions.
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Resuscitative endovascular balloon occlusion of the aorta (REBOA) during cardiopulmonary resuscitation (CPR) increases coronary and cerebral perfusion pressure, which might improve neurologically intact survival after refractory cardiac arrest. We investigated the feasibility of REBOA during CPR in the emergency department. ⋯ In this pilot trial, REBOA during CPR was successful in 60% of attempts. Long resuscitation times before start of the procedure might explain difficult insertion and missing effects. Nevertheless, insertion of REBOA in patients suffering from non-traumatic cardiac arrest is feasible and might increase coronary and cerebral perfusion pressures and perfusion.
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Review
Acute clinical deterioration and consumer escalation in the hospital setting: A literature review.
Consumer escalation systems that allow patients and/or their family/carers to escalate concerns about clinical deterioration have been proposed as a way of enhancing patient safety. However, evidence to guide implementation or to support system effectiveness remains unclear. ⋯ The ability of consumer escalation processes to achieve their underlying goals is still to be adequately assessed. Further research is required to inform how to best implement, support and optimise consumer escalation systems.