Resuscitation
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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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To establish a uniform framework describing the system and organisation of emergency medical response centres and the process of emergency medical dispatching (EMD) when reporting results from studies in emergency medicine and prehospital care. ⋯ In September 2005 a task force of 22 experts from 12 countries met in Stavanger; Norway at the Utstein Abbey to review data and establish a common terminology for medical dispatch centres including core and optional data to be used for health monitoring, benchmarking and future research.
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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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Controlled Clinical Trial
Recorded heart sounds for identification of ventricular tachycardia.
The ECG discrimination of ventricular tachycardia (VT) vs. supraventricular tachycardia (SVT) is both important and often difficult. In this study, we tested the hypothesis that recorded digital cardiac acoustical data reflect hemodynamic changes that can be used for VT detection. ⋯ VT is associated with both decreased S1 intensity and increased beat-to-beat S1 variability. The electronic recording and digital processing of digital heart sound data is useful for identifying VT and may facilitate the differential diagnosis of clinically important tachyarrhythmias, particularly in emergency situations where advanced techniques such as electrophysiology studies are not available.
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To determine the incidence and success rate of out-of-hospital tracheal intubation (TI) and ventilation of children, taking account of the type of healthcare provider involved. ⋯ We do not recommend early TI by EMS-paramedics in children with a GCS of 3-4. The rate of complications of this procedure is unacceptably high. BVMV is the preferred choice for ventilation by paramedics, whenever possible. Out-of-hospital TI performed by HMT is safe and effective. The HMT has skills in advanced airway management not provided by the EMS.