Resuscitation
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Cardiopulmonary resuscitation (CPR) has been used in hospitals for approximately 40 years. Nurses are generally the first responders to a cardiac arrest and initiate basic life support while waiting for the advanced cardiac life support team to arrive. ⋯ Attitudes of individual nurses may influence the speed and level of involvement in true emergency situations. This paper uses the theories of reasoned action and planned behaviour to examine some behavioural issues with CPR involvement.
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The outcome from in-hospital cardiac arrest has improved little since the implementation of cardiopulmonary resuscitation 40 years ago. Early defibrillation improves survival following ventricular fibrillation and pulseless ventricular tachycardia. The emergence of automatic external defibrillators and advisory defibrillators has been heralded as the answer to defibrillation delays in-hospital. ⋯ There is limited primary research evaluating automatic external defibrillators in-hospital. Manual defibrillators remain the most commonly used device for in-hospital defibrillation. Automated external defibrillators offer an alternative to manual defibrillation providing they have a screen and manual override capability, and the technology for pacing is close to hand. For in-hospital automatic external defibrillator programmes to be effective a change in nursing philosophy must occur, and defibrillation must become an expected rather than an extended nursing role.
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the aim of the study is to investigate the effect of thrombolytic therapy on neurological outcome in patients after cardiac arrest due to acute myocardial infarction. Laboratory investigations have demonstrated that thrombolytic therapy after cardiopulmonary resuscitation improves neurological function. ⋯ thrombolytic therapy after cardiac arrest due to acute myocardial infarction is associated with improved neurological outcome.
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Comparative Study
Estimated cost effectiveness of a police automated external defibrillator program in a suburban community: 7 years experience.
To estimate the cost effectiveness of a 7-year police automatic external defibrillator (AED) program in four suburban communities. ⋯ Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.
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Practice Guideline Guideline
Defibrillators in public places: the introduction of a national scheme for public access defibrillation in England.
To implement a government-led project-the 'Defibrillators in Public Places' Initiative-to deploy Automated External Defibrillators (AEDs) in public places. ⋯ A Defibrillator Advisory Committee (DAC) was formed to assist the government with the implementation of the project. Its particular tasks were to: recommend criteria for the selection, training and assessment of those individuals likely to use the devices; procure the equipment necessary for the implementation of the project; procure the training services required for the implementation of the project; ensure the AEDs are sited where they are most likely to be of benefit; establish a mechanism to audit the use of this equipment and the outcome of this initiative. To co-ordinate this project a National Project Manager was appointed. Consultation with Ambulance Services NHS Trusts established the places where cardiac arrest occurred under circumstance where the availability of a defibrillator might be most likely to be effective. Defibrillators were procured under the direction of the NHS Purchasing and Supply Agency in conjunction with medical advisors. Devices that were reliable, safe, simple in operation and with good data retrieval systemes were selected. Training contracts were awarded under the direction of the NHS Purchasing and Supply Agency in conjunction with medical and educational advisors. Organisations with accredited training experience and possessing the appropriate administrative and data handling abilities were selected. The ability to undertake training in an area concordant with current NHS regions was an essential requirement. In the first stage of implementation, pilot trials were successfully established at sites where persons were willing to be trained in the use of automated defibrillators. Arrangements for national progress of the project were made on the basis of the experience gained at pilot sites. A robust system for monitoring the outcome of the project has been established in partnership with the Resuscitation Council UK. The long-term success of this innovative project requires: Continuing central administrative support in the short to medium term. Central audit and data collection. The results of this project should contribute to national databases being established by the Resuscitation Council UK. Continuing adequate funding. The recognition that the provision of defibrillation to the victims of cardiac arrest is a key feature of the NHS.