Resuscitation
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The use of vasopressin instead of adrenaline/epinephrine during resuscitation improves vital organ perfusion, but the effects on mesenteric perfusion following successful resuscitation are not fully evaluated. The present study was designed to compare the effects of vasopressin and adrenaline/epinephrine, given to rats during resuscitation from ventricular fibrillation, on to mesenteric ischaemia, as determined by intestinal mucosal tonometer pCO(2) during the postresuscitation period. ⋯ We conclude that in this rat model the administration of vasopressin instead of adrenaline/epinephrine for CPR tends to be associated with lower resuscitation success, but less mesenteric ischaemia during the postresuscitation period in successfully resuscitated rats.
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Comparative Study
Endotracheal drug administration during out-of-hospital resuscitation: where are the survivors?
Drugs administered endotracheally are effectively absorbed during normal spontaneous cardiac activity. However, animal cardiac arrest studies and limited clinical investigations do not support either the use of endotracheal (ET) drugs in doses currently recommended for adults or the method of direct endotracheal instillation. The purpose of this study was to compare the effect of intravenous (IV) and ET drug therapy on outcome from out-of-hospital cardiac arrest secondary to all cardiac arrest rhythms. ⋯ For our out-of-hospital advanced rescuer system, ET drugs at recommended doses (twice the IV dose) injected into an ET tube during cardiac arrest and CPR were of no benefit.
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Automated external defibrillators (AEDs) are used with increasing frequency in the United States by first responders (FR) such as police officers (PO) or firefighters (FF). However, FR satisfaction with use of AEDs has not been investigated. We hypothesized that FR satisfaction is comparable with that of paramedics (PA) and that, among those who have defibrillated with AEDs, those who have restored a pulse before PA arrival have a higher level of satisfaction than those who have not restored a pulse. ⋯ FR demonstrated a high level of satisfaction with using AEDs, and also had a favorable attitude toward implementation of AED use. Restoration of a pulse was clearly a factor responsible for a higher satisfaction. This positive attitude should encourage further implementation of early defibrillation programs in non-medical first responder settings.
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Surf lifesavers in Australia undertake numerous resuscitation scenarios in the course of their training and examination. The standard teaching and examination strategy is for the scenario to end with return of spontaneous circulation (ROSC) and then breathing. This study was performed to assess the effect of this training technique on lifesavers' expectation of successful resuscitation and to determine the effect of experience on these expectations. ⋯ Surf lifesavers in the Sydney Northern Beaches branch have an exaggerated expectation of the chances of successful CPR following cardiac arrest. This expectation did not change with time since learning CPR or participation in actual resuscitations. New models for CPR education need to be investigated.