Resuscitation
-
Comparative Study
Cerebral density on CT immediately after a successful resuscitation of cardiopulmonary arrest correlates with outcome.
To evaluate whether cerebral CT findings taken immediately after successful resuscitation from cardiopulmonary arrest (CPA) correlate with the outcome or not. ⋯ Although the influence of age cannot be disregarded, the CT number of the putamen and cortex, and also the corticomedullary contrast correlated with outcome of hypoxic encephalopathy even when cerebral CT was performed within 1 h after ROSC following CPA.
-
In 1994, all emergency medical services (EMS) ambulance officers in Singapore were trained to perform pre-hospital defibrillation with semi-automated external defibrillators (AED). All non-traumatic cardiac arrest patients over 10 years old were included, excluding those who were obviously dead and children below 36 kg. The data were collected by the ambulance officers according to the Utstein guidelines. ⋯ Our survival rate of bystander witnessed VF/VT arrest is comparable to large metropolitan cities in the USA. The determinants of survival include EMS witnessed arrest and VF/VT arrest. Increased quantity and quality of bystander CPR rate may improve the outcome in bystander witnessed cardiac arrest.
-
Comparative Study
A study comparing the usability of fully automatic versus semi-automatic defibrillation by untrained nursing students.
Current international guidelines prefer the use of semi-automatic external defibrillators (SAEDs) over fully automatic external defibrillators (FAEDs). However, there is a lack of evidence supporting this recommendation. We conducted a study of usability with nursing students comparing the FAED version against the SAED version of the Lifepak CR Plus AED (Medtronic, Redmond, USA). We hypothesized that FAED use would limit the number of operator-device interactions, thereby increasing compliance by the rescuer, safety and speed. ⋯ Despite a lack of BLS skills and AED training, the majority of students demonstrated safe and effective use of the AED. The use of the FAED version of the CR Plus resulted in increased compliance with the protocol and reduced variability in time to deliver three shocks. Further research is needed to confirm these findings in other groups of first responders.
-
Although modern defibrillators are nearly always successful in terminating ventricular fibrillation (VF), multiple defibrillation attempts are usually required to achieve return of spontaneous circulation (ROSC). This is potentially deleterious as cardiopulmonary resuscitation (CPR) must be discontinued during each defibrillation attempt which causes deterioration in the heart muscle and reduces the chance of ROSC from later defibrillation attempts. In this work defibrillation outcomes are predicted prior to electrical shocks using a neural network model to analyse VF time series in an attempt to avoid defibrillation attempts that do not result in ROSC. ⋯ Pre-shock VF ECG time series can be classified according to the defibrillation conversion to a return of spontaneous circulation (ROSC) or No-ROSC.
-
Comparative Study
Should there be a change in the teaching of airway management in the medical school curriculum?
To evaluate the use of the Laryngeal Mask Airway (LMA), the oesophageal-tracheal combitube (ETC) and the tracheal tube (TT) by medical students, with a view to recommend changes to the medical school curriculum. ⋯ The use of the TT is difficult and the skills acquired by the medical students deteriorate significantly over time. The LMA and the ETC seem to have an advantage over the TT in that they are more easily learnt and the skills better retained. It is recommended that these alternative devices be included in the medical school curriculum for airway management.