Resuscitation
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When children's weight cannot be measured during medical emergencies, it must be estimated, as weight is required for many interventions. Age-based formulas are the oldest weight estimation systems in children, but have been shown to be very inaccurate in many studies. This aim of this study was to evaluate the accuracy of age- and length-based formulas and to see if a measure of body habitus could be used to improve the performance of these formulas. ⋯ This was an analysis of data from a sample of 1085 children aged from 1 month to 16 years, collected from four Emergency Departments in Johannesburg, South Africa. Basic demographic and anthropometric data was collected and each child had a visual assessment of body habitus, quantified as a habitus score. Weight estimates from 20 existing age-based formulas and two length-based formulas were then compared against measured weight to determine their accuracy. Age- and length-based, habitus-modified models were developed and similarly evaluated.
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Observational Study
A Novel Educational Outreach Approach to Teach Hands-Only Cardiopulmonary Resuscitation to the Public.
The American Heart Association set goals in 2010 to train 20 million people annually in cardiopulmonary resuscitation and to double bystander response by 2020. These ambitious goals are difficult to achieve without new approaches. ⋯ There is noticeable public interest in learning Hands-Only CPR by using an airport kiosk and an airport is an opportune place to engage a layperson in learning Hands-Only CPR. The average quality of Hands-Only CPR by the public needs improvement and adding kiosks to other locations in the airport could reach more people and could be replicated in other major airports in the United States.
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Comparative Study
Characteristics and Outcomes of Out-of-Hospital Sudden Cardiac Arrest According to the Time of Occurrence.
The impact of time of occurrence has been extensively evaluated for in-hospital cardiac arrests but less for Out-of-Hospital Cardiac Arrests (OHCA). We assessed the impact of the time of occurrence on the characteristics and prognosis of OHCA. ⋯ Off-hours OHCA have a 30% lower survival rate, mainly due to differences in initial management (bystander CPR and AED use), illustrating the need to improve bystanders' responsiveness in all circumstances.
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Observational Study
Lower chest compression fraction associated with ROSC in OHCA patients with longer downtimes.
To investigate the relationship between chest compression fraction (CCF) and survival outcomes in OHCA, including whether the relationship varied based upon downtime from onset of arrest to provision of cardiopulmonary resuscitation (CPR) by emergency medical services (EMS). ⋯ We demonstrated an inverse relationship between CCF and ROSC that varied depending upon the time from arrest to provision of EMS-CPR.
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The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. ⋯ NIPPV was safely and effectively used in the delivery room settings to provide respiratory support for VLBW infants with less need for intubation, chest compressions, epinephrine administration and subsequent invasive ventilation.