Resuscitation
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Comparative Study
London bombings July 2005: the immediate pre-hospital medical response.
On July 7th 2005 a series of terrorist bombs exploded in London. The transport system was targeted and at least 54 passengers were killed and around 700 injured. This paper describes the immediate pre-hospital medical response to the four scenes. From the perspective of the London Helicopter Emergency Medical Service the deployment, difficulties on scene and the initial lessons learned are discussed.
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To study the concentration of oxygen flowing passively from the front and the rear parts of different brands of self-inflating bag valve mask ventilation devices at different oxygen flows and that flowing actively from the front part at different ventilation rates. ⋯ The Ambu device can provide 100% oxygen from its rear part even at low flow rates and 100% oxygen during active ventilation provided at least 10 L/min oxygen is used. The VBM is at a disadvantage when the oxygen source faces a hole; as the jet flowing in the bag causes a Venturi effect; which sucks air in from outside and dilutes the oxygen concentration provided. The ridge type does not have this problem. Ventilation at a rate of 30 min(-1) produced a higher oxygen concentration. The operator should be aware of the limitations of the device used.
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Randomized Controlled Trial Comparative Study
Out-of-hospital cardiac arrest rectilinear biphasic to monophasic damped sine defibrillation waveforms with advanced life support intervention trial (ORBIT).
Although biphasic defibrillation waveforms appear to be superior to monophasic waveforms in terminating VF, their relative benefits in out-of-hospital resuscitation are incompletely understood. Prior comparisons of defibrillation waveform efficacy in out-of-hospital cardiac arrest (OHCA) are confined to patients presenting in a shockable rhythm and resuscitated by first responder (basic life support). This effectiveness study compared monophasic and biphasic defibrillation waveform for conversion of ventricular arrhythmias in all OHCA treated with advance life support (ALS). ⋯ Shock success to an organized rhythm comparing step-up protocol for energy settings demonstrated the RLB waveform was superior to MDS in ALS treatment of OHCA. Survival rates for both waveforms are consistent with current theories on the circulatory and metabolic phases of out-of-hospital cardiac arrest.
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Comparative Study
Providing automated external defibrillators to urban police officers in addition to a fire department rapid defibrillation program is not effective.
The aim of this study was to determine if providing automated external defibrillators (AEDs) to urban police officers would increase the proportion of patients with out-of-hospital cardiac arrest (OOH-CA) who were discharged alive from the hospital. ⋯ Equipping police cars with AEDs in an urban area where the fire department-based first response system also carries defibrillators did not improve the hospital discharge survival rate for victims of OOH-CA.
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Comment Letter Comparative Study
A predictive model for survival after in-hospital cardiopulmonary arrest.