Nihon rinsho. Japanese journal of clinical medicine
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The International Liaison Committee on Resuscitation (ILCOR) recommended therapeutic hypothermia treatment as follows. Comatose adult patients with spontaneous circulation after out-of-hospital VF cardiac arrest should be cooled to 32 to 34 degrees C for 12 to 24 hours. ⋯ Therapeutic hypothermia may be beneficial for adolescents who remain comatose following resuscitation from sudden witnessed out-of-hospital VF cardiac arrest, and may be considered for infants and children who remain comatose following resuscitation from cardiac arrest. Newly born infants born at or near-term with evolving moderate to severe hypoxic-ischemic encephalopathy should be offered therapeutic hypothermia.
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The new international consensus and guidelines were published by American Heart Association in October 2010. These guidelines include many important changes in pediatric basic life support(BLS) based on many evidences. ⋯ In addition, pediatric chain of survival is revised and the section of "Look, Listen, Feel" is deleted. These changes are recommended in order to simplify training with the hope that more pediatric victims will consequently receive bystander CPR.
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The Fire and Disaster Management Agency (FDMA) of Japan started a nationwide, population-based, cohort study in 2005 and keeps collecting the ambulance transportation records of out-of-hospital cardiac arrests in Japan based on the standardized Utstein style. By analyzing the outcomes of bystander-witnessed arrests among patients who had ventricular fibrillation and arrests, the rate of survival at 1 month is 11.4% and the rate of survival with minimal neurologic impairment at 1 month is 7.1%. The rate of survival at 1 month and the rate of survival with minimal neurologic impairment at 1 month are improved by bystander (family member or other) CPR, early CPR by EMS personnel, and the administration of a shock with the use of a public-access AED. It is important to improvement the ambulance service system by using these statistical data.
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It is medical equipment in "Advanced managed care equipment and specific maintenance medical equipment" for around and the life support though is thought that AED operates if it always turns on power like the television not used by the sense like home appliance as a result of spreading in general widely. It is management that it is important to always check the expiration date etc. of the indicator and the articles of consumption of AED to use it at any time when AED is set up, and requested by those who set it up.
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Important changes or points of emphasis in the recommendations for pediatric advanced life support are as follows. In infants and children with no signs of life, healthcare providers should begin CPR unless they can definitely palpate a pulse within 10 seconds. New evidence documents the important role of ventilations in CPR for infants and children. ⋯ The initial defibrillation energy dose of 2 to 4J/kg of either monophasic or biphasic waveform. Both cuffed and uncuffed tracheal tubes are acceptable for infants and children undergoing emergency intubation. Monitoring capnography/capnometry is recommended to confirm proper endotracheal tube position.