Resuscitation
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Randomized Controlled Trial Multicenter Study Clinical Trial
Measuring survival rates from sudden cardiac arrest: the elusive definition.
Measuring survival from sudden out-of-hospital cardiac arrest (OOH-CA) is often used as a benchmark of the quality of a community's emergency medical service (EMS) system. The definition of OOH-CA survival rates depends both upon the numerator (surviving cases) and the denominator (all cases). ⋯ Reported OOH-CA rates and survival rates vary widely, depending upon the definitions applied to events. Rigorous assessment of treatments applied to improve survival can be obscured by inappropriate definitions. Large-scale randomized interventions designed to improve survival from OOH-CA can be evaluated based upon the absolute numbers of patients surviving, rather than a change in the proportion surviving.
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To determine if attendance at a Resuscitation Council (UK) immediate life support (ILS) course influenced the skill deployment of nurses at a subsequent cardiac arrests. ⋯ ILS training alone may be insufficient to increase deployment of these skills by nurses who are not cardiac arrest team members. A more supportive approach, involving individual coaching of these individuals may need to be considered.
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Comparative Study
Vasopressin versus continuous adrenaline during experimental cardiopulmonary resuscitation.
To evaluate the effects of a bolus dose of vasopressin compared to continuous adrenaline (epinephrine) infusion on vital organ blood flow during cardiopulmonary resuscitation (CPR). ⋯ In this experimental model, vasopressin caused a greater increase in cortical cerebral blood flow and lower cerebral oxygen extraction during CPR compared to continuous adrenaline. Furthermore, vasopressin generated higher coronary perfusion pressure and increased the likelihood of restoring spontaneous circulation.
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We assessed the familiarity of the general public with automated external defibrillators (AEDs) and their willingness to use them. ⋯ Although a substantial number of people in this setting were willing to use an AED, education regarding legal liability and proper use of the machines increased the reported likelihood of use. Further public education may be necessary to provide optimally effective public access defibrillation programs.
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Comparative Study
Percutaneous transcricoid jet ventilation compared with surgical cricothyroidotomy in a sheep airway salvage model.
We developed a large animal model of the "cannot intubate/cannot ventilate" (CNI/V) scenario to compare percutaneous transcricoid manual jet ventilation (MJV) with surgical cricothyroidotomy (SC). ⋯ Using a realistic model of CNI/V we found no difference in respiratory or hemodynamic variables between MJV and SC. Adequate ventilation and perfusion was maintained solely by MJV for up to 20 min.