Resuscitation
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Comparative Study
Emergency echocardiography to detect pericardial effusion in patients in PEA and near-PEA states.
Emergency echocardiography (EM echo) has been proposed to assist in decision-making in patients with pulseless electric activity (PEA) or PEA-like states. We observed the value of EM echo by emergency physicians in detecting pericardial effusion in patients in PEA and near PEA states. ⋯ Emergency echocardiography performed by emergency physicians in patients in PEA or near PEA states can detect pericardial effusions with correctable etiologies versus true PEA with ventricular standstill.
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The impact of the immediate in-hospital post-resuscitation care after out-hospital cardiac arrest is not well known. Based on treatment variables and laboratory findings a multiple logistic regression model was created for the prediction of survival at 6 months from the event. ⋯ This study suggests that in-hospital factors are associated with survival from out-of-hospital cardiac arrest. The mean blood glucose and serum potassium during the first 72 h of treatment and the use of beta-blocking agents were significantly and independently associated with survival.
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The charts of all adult patients with accidental hypothermia who were admitted to a single academic hospital during a 10 year period were retrospectively retrieved. The aim was to identify factors associated with survival of those with hypothermic cardiac arrest. Of 75 admitted patients, 44 were found to be haemodynamically stable and not to require invasive rewarming measures. ⋯ Logistic regression analysis showed that of the 23 patients, 22 could be correctly classified as survivor or nonsurvivor based on the level of serum potassium and arterial pCO2. It is concluded that patients with cardiac arrest due to primary hypothermia tolerate long periods of conventional CPR before institution of CPB. The possible predictive role of serum potassium and arterial pCO2 needs further evaluation.
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To clarify the incidence and survival rate of bystander-witnessed out-of-hospital cardiac arrests (OHCA) with cardiac etiology in Osaka Prefecture, Japan, with a population of nearly 9 million according to the Utstein style. ⋯ The incidence of bystander-witnessed (OHCA) with cardiac etiology and VF or VT were remarkably low compared with those reported by other studies conducted in some areas of Europe or the USA.
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The introduction of the European Resuscitation Guidelines (2000) for cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) prompted the development of an up-to-date and reliable method of assessing the quality of performance of CPR in combination with the use of an AED. The Cardiff Test of basic life support (BLS) and AED version 3.1 was developed to meet this need and uses standardised checklists to retrospectively evaluate performance from analyses of video recordings and data drawn from a laptop computer attached to a training manikin. This paper reports the inter- and intra-observer reliability of this test. ⋯ The inter- and intra-observer reliability for the majority of the variables in the Cardiff Test of BLS and AED version 3.1 is satisfactory. However, reliability is less acceptable with respect to shaking when checking for responsiveness, initial check/clearing of the airway, checks for signs of circulation, time to first shock and performance of interventions in the correct sequence. Further research is required to determine if modifications to the method of assessing these variables can increase reliability.