European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Comparative Study
Quality of resuscitation by first responders using the 'public access resuscitator': a randomized manikin study.
The CAREvent Public Access Resuscitator (PAR) is an electronic, oxygen-driven cardiopulmonary resuscitation (CPR) device allowing volume-controlled ventilation with a face mask and guiding the rescuer through the resuscitation with voice prompts and visual indications. We hypothesized that 1 year after initial training, the efficacy of ventilation skills (primary outcome) and compression skills (secondary outcome) by first responders using the PAR would be superior compared with CPR with only a face mask. ⋯ Compared with the face mask, PAR improved tidal volume, compressions per minute and hand position in a manikin setting.
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Adequate chest compression (CC) depth is crucial for resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5-6 cm CC depth. This nonrandomized cohort study investigated new strategies to improve CC performance. ⋯ A simple 5-s instructor's intervention during the CPR training significantly improved the performance of the female rescuers and helped them achieve the CC depth required by 2010 resuscitation guidelines. Andrew's manoeuvre is most effective among the women with the lowest body weight.
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The aim of this study was to assess the walkout rate and to identify influencing patient and visit characteristics on walkout. Furthermore, we assessed the reasons for leaving and medical care needs after leaving. ⋯ The average observed daily walkout rate was 1.4 patients over the 4-month period. In general, walkouts are self-referrals with lower urgent complaints, arriving during the evening or night shift or during crowded conditions. Most walkouts leave because of perceived long waiting times.
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The prevalence of obesity is rising worldwide. To investigate how fixed-wing air ambulances handle bariatric transfers, we conducted a survey addressing logistical and medical issues. A questionnaire was sent to 24 air ambulance companies in Europe. ⋯ Dedicated tools for transferring, bedding, and securing patients are available very inconsistently. Medical provisions such as airway management, monitoring, and vascular access for the obese reach high standards. While medical resources for obesity-related problems reach a high standard, poor logistical preparations could lead to harm for patient and medical escort alike.
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Previous studies have reported that civilian transport is a mortality risk factor in low-resource communities. Few studies have analyzed the chief complaints associated with mortality involving civilian transport after an earthquake.Therefore, the present study was conducted to determine whether mortality resulting from medical professional transport differs from that involving civilian transport, and if so, the chief complaints associated with mortality involving civilian transport after the Wen-chuan earthquake. ⋯ Altered mental status, trunk injury, and shortness of breath were the significant chief complaints associated with mortality involving civilian transport to the hospital after the Wen-chuan earthquake. Our data suggest that patients with any of these complaints should be transported by medical professionals, not civilians, to the nearest hospital for treatment.