Resuscitation
-
Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills competency can be tested using a checklist of component skills, individually graded "pass" or "fail." Scores are typically calculated as the percentage of skills passed, but may differ from an instructor's overall subjective assessment of simulated CPR or AED adequacy. ⋯ Our findings suggest that instructors in public CPR and AED classes may tend to down-weight process skills and to excuse step sequencing errors when evaluating CPR and AED skills subjectively for overall proficiency. Testing methods that relate classroom performance to actual performance in the field and to clinical outcomes require further research.
-
Cardiac arrest is responsible for significant morbidity and mortality, with consistently poor outcomes despite the rapid availability of prehospital personnel for defibrillation attempts in patients with ventricular fibrillation (VF). Recent evidence suggests a period of cardiopulmonary resuscitation (CPR) prior to defibrillation attempts may improve outcomes in patients with moderate time since collapse (4-10 min). ⋯ The performance of bystander CPR prior to defibrillation by EMS personnel is associated with improved survival among patients with time since collapse longer than 4 min but not less than 4 min. These data are consistent with the three-phase model of cardiac arrest.
-
Comparative Study
Body surface mapping versus the standard 12 lead ECG in the detection of myocardial infarction amongst emergency department patients: a Bayesian approach.
To determine if body surface mapping (BSM) is better than the standard 12 lead ECG in the diagnosis of acute myocardial infarction amongst emergency department patients. ⋯ BSM has a higher sensitivity, but a lower specificity for the diagnosis of myocardial infarction.
-
Mild therapeutic hypothermia has shown to improve neurological outcome after cardiac arrest. Our study investigated the efficacy and safety of cold simple intravenous infusions for induction of hypothermia after cardiac arrest preceding further cooling and maintenance of hypothermia by specialised endovascular cooling. ⋯ Our results indicate that induction of mild hypothermia with infusion of cold fluids preceding endovascular cooling is safe and effective.
-
Measuring different intervals during cardiopulmonary resuscitation is a key element of resuscitation performance. For accurate time measurements, the internal clocks of automated external defibrillator (AEDs) need to be synchronized with the dispatch centre time. ⋯ Synchronisation of AED clocks is not widespread in Finland. Instructions to synchronize have been issued in a minority of EMS systems. Despite this, time deviations are large, and erroneous times are recorded.