Resuscitation
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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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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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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 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.