Resuscitation
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Randomized Controlled Trial
Post-admission outcomes of participants in the PARAMEDIC trial: a cluster randomised trial of mechanical or manual chest compressions.
The PARAMEDIC cluster randomised trial evaluated the LUCAS mechanical chest compression device, and did not find evidence that use of mechanical chest compression led to an improvement in survival at 30 days. This paper reports patient outcomes from admission to hospital to 12 months after randomisation. ⋯ There were no clinically important differences identified in outcomes at long term follow-up between those allocated to the mechanical chest compression compared to those receiving manual chest compression.
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To determine whether neurologic consultation influences the use of therapeutic hypothermia. ⋯ The involvement of a neurologist in cardiac arrest patients is associated with increased use of therapeutic hypothermia, though therapeutic hypothermia for cardiac arrest likely remains underutilized.
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Increased Cardiac Arrest Survival and Bystander Intervention in Enclosed Pedestrian Walkway Systems.
Cities worldwide have underground or above-ground enclosed walkway systems for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrests (OHCAs). The characteristics and outcomes of OHCAs that occur in such systems are unknown. ⋯ This study suggests that OHCAs in enclosed pedestrian walkway systems are uniquely different from other public settings. Bystander resuscitation efforts are significantly more frequent and survival rates are significantly higher. Urban planners in similar infrastructure systems worldwide should consider these findings when determining AED placement and public engagement strategies.
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To compare the effectiveness of different compression-to-ventilation methods during cardiopulmonary resuscitation (CPR) in patients with cardiac arrest. ⋯ Our results demonstrated that for adults, CPR 30:2 is associated with better survival and favourable neurological outcomes when compared to CPR 15:2. For children, more patients receiving CPR with either 15:2 or 30:2 compression-to ventilation ratio experienced favourable neurological function, survival, and ROSC when compared to CO-CPR for children of all ages, but for children <1years of age, no statistically significant differences were observed.
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CPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. ⋯ Showing a UBV at a mass gathering sporting event is associated with improved CPR responsiveness and performance for lay bystanders. This data provides further support for the use of mass media interventions.