Prehospital and disaster medicine
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Prehosp Disaster Med · Apr 2002
Comparative StudyCan the "golden hour of shock" safely be extended in blunt polytrauma patients? Prospective cohort study at a level I hospital in eastern Switzerland.
The objective was to test, in this trauma system, the North American hypothesis that exceeding the 60-minute limit for the entire prehospital time ("golden hour of shock") increases mortality of blunt polytrauma patients. ⋯ It appears in this trauma system, in which emergency physicians often are deployed, that the 'golden hour of shock' can be extended safely in many blunt polytrauma patients, since this was associated with better survival figures than in those patients for whom the time was < 1 hour.
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Prehosp Disaster Med · Apr 2002
Comparative StudyRapid on-site defibrillation versus community program.
For patients who suffer out-of-hospital cardiac arrest, the time from collapse to initial defibrillation is the single most important factor that affects survival to hospital discharge. The purpose of this study was to compare the survival rates of cardiac arrest victims within an institution that has a rapid defibrillation program with those of its own urban community, tiered EMS system. ⋯ This study provides further evidence that PAD Programs may enhance cardiac arrest survival rates and should be considered for any venue with large numbers of adults as well as areas with difficult medical access.
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Prehosp Disaster Med · Apr 2002
Resuscitation for patients with out-of-hospital cardiac arrest: Singapore.
To evaluate characteristics and outcome of out-of-hospital cardiac arrest (OHCA) patients presenting to the Emergency Department (ED), and to examine factors that could be used to determine to prolong or abort resuscitation for these patients. ⋯ The survival rate for patients with OHCA after ED resuscitation is similar to the results from other studies. There is a need to increase the awareness and delivery of basic life support by public education. Automatic External Defibrillators (AED) should be available widely to ensure that the chance of early defibrillation is increased. Prolonged resuscitation efforts appear to be futile for OHCA patients if the time from cardiac arrest until arrival in the ED is > or = 30 minutes coupled with no ROSC, and if continuous asystole has been documented for > 10 minutes.