Resuscitation
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Randomized Controlled Trial
Work of CPR during two different compression to ventilation ratios with real-time feedback.
The 2005 Emergency Cardiac Care guidelines for basic life support (BLS) recommend compression to ventilation ratio of 30:2. The effect of the additional exertion required to deliver more chest compressions may present a considerable physical burden on the provider. ⋯ In a cohort of healthcare providers, increasing the CPR ratio from 15:2 to 30:2 did not change physical or perceived exertion during a 5-min bout of CPR when continuous, real-time feedback is provided. The 30:2 compression to ventilation ratio resulted in more chest compressions per minute without decreasing CPR quality.
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Randomized Controlled Trial Comparative Study
Basic life support refresher training of nurses: individual training and group training are equally effective.
Basic life support (BLS) skills of hospital nurses are often poor. We compared individual BLS refresher training (IT; one instructor to one trainee) with group refresher training (GT; one instructor to six trainees). We hypothesised that IT would result in better skill acquisition and retention. ⋯ There was no difference in IT and GT immediately and 10 months after training. However, training time per nurse for IT was only one fifth, whereas total instructor time did not increase. Although not superior in outcome, IT may be a cost-effective alternative for GT.
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Assessing the neurological and disability status of cardiac arrest (CA) survivors is important for evaluating the outcomes of resuscitation interventions. The Cerebral Performance Category (CPC)--the standard outcome measurement after CA--has been criticized for its poorly defined, subjective criteria, lack of information regarding its psychometric properties, and poor relationships with long-term measures of disability and quality of life (QOL). This study examined the relationships among the CPC and measures of global disability and QOL at discharge from the hospital and at 1 month after CA. ⋯ When compared to disability and quality of life measures, it is apparent that the CPC has limited ability to discriminate between mild and moderate brain injury. The validity of using the chart review method for obtaining scores is questionable.
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Randomized Controlled Trial
Effects of audio tone guidance on performance of CPR in simulated cardiac arrest with an advanced airway.
Despite the emphasis of cardiopulmonary resuscitation (CPR) quality, the performance of on-site CPR is reported to be frequently unsuccessful. In order to improve CPR quality, various feedback systems have been developed, but they have not yet been widely used on site due to low economic efficiency. The present study was attempted to determine whether CPR quality can be improved using audio tone guidance. ⋯ Audio tone guidance ensures better chest compression rate and ventilation rate but this does not necessarily result in a better CPR quality.
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Multicenter Study
Risk of cardiopulmonary arrest after acute respiratory compromise in hospitalized patients.
Hospitalized patients with serious medical conditions such as shock, aspiration, pulmonary edema or stroke may develop acute respiratory compromise (ARC) requiring rescue treatment by medical emergency teams. We determined the characteristics and clinical course of hospitalized patients experiencing ARC as well as their risk of developing subsequent CPA. ⋯ Approximately one in six patients experiencing initial ARC deteriorates to CPA. Most CPA occur within 10 min of ARC recognition. Improved ARC recognition, hospital emergency team response and airway management may potentially enhance care and outcomes for these critically ill patients.