Läkartidningen
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Automated external defibrillators (AED) have become an important part of the »the chain of survival« in case of sudden cardiac arrest (SCA), where early defibrillation is lifesaving. The American Heart Association demands that AEDs have a specificity of >99 % to recognize normal sinus rhythm and >95 % for the other non-shockable rhythms. ⋯ We present five cases in which AED recommended shock for apparently non-shockable rhythms. This indicates the necessity to systematically reevaluate AED performance.
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Three recent randomised trials have shown a lack of effect of EGDT for the treatment of severe sepsis and septic shock. Notably, control group care was excellent in all trials, including early recognition, early and aggressive fluid resuscitation and prompt administration of antibiotics, and was reflected in a lower than expected mortality. The discussion emphasizes the need for continued vigilance and early aggressive management.