Resuscitation
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Randomized Controlled Trial Multicenter Study
Early blood transcriptomic signature predicts patients' outcome after out-of-hospital cardiac arrest.
Early prognostication is a major challenge after out-of-hospital cardiac arrest (OHCA). ⋯ A transcriptomic signature involving a counterbalance between adaptive and innate immune responses is able to predict neurological outcome very early after hospital admission after OHCA. This deserves confirmation in a larger population.
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To systematically evaluate the literature on interventions that improve skills retention following advanced structured resuscitation training programs designed for healthcare professionals. ⋯ Simulation-based interventions, refresher courses and adjustments to the content delivery of advanced structured resuscitation training courses were found to have the greatest impact on skills retention. However, due to significant heterogeneity and methodological flaws in the available studies, no definitive conclusions can be made regarding other interventions. Overall, there is a paucity of skills retention research and further high-quality randomized controlled trials are needed to determine the optimal intervention and design for resuscitation training that would maximize skills retention.
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Randomized Controlled Trial Multicenter Study
The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial.
Little is known about how best to motivate healthcare professionals to engage in frequent cardiopulmonary resuscitation (CPR) refresher skills practice. A competitive leaderboard for simulated CPR can encourage self-directed practice on a small scale. The study aimed to determine if a large-scale, multi-center leaderboard improved simulated CPR practice frequency and CPR performance among healthcare professionals. ⋯ A competitive leaderboard was not associated with an increase in self-directed simulated CPR practice or improved performance.
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Multicenter Study
Time of on-scene resuscitation in out of-hospital cardiac arrest patients transported without return of spontaneous circulation.
In out-of-hospital cardiac arrest (OHCA), return of spontaneous circulation (ROSC) on scene occurs only in a minority of patients. The optimal duration of resuscitation on scene before transport with ongoing cardiopulmonary resuscitation (CPR) is unknown. ⋯ In OHCA patients transported with ongoing CPR the survival rate significantly declines when time on scene increases.
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To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. ⋯ All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.