Resuscitation
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Randomized Controlled Trial
Impact of adding video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests--a randomized controlled study.
Both ventilations and compressions are important for victims of prolonged cardiopulmonary resuscitation (CPR) and asphyxial arrest. Dispatch assistance increases bystander CPR, but the quality of dispatcher-assisted CPR (DA-CPR), especially rescue breathing, remains unsatisfactory. This study was conducted to assess the impact of adding interactive video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests. ⋯ Adding video communication to dispatch instructions improved the quality of bystander rescue breathing, including higher proportion of airway opened, and larger volume of ventilation delivered, in simulated cardiac arrests.
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Comparative Study
Shock outcome prediction before and after CPR: a comparative study of manual and automated active compression-decompression CPR.
We report on a study designed to compare the relative efficacy of manual CPR (M-CPR) and automated mechanical CPR (ACD-CPR) provided by an active compression-decompression (ACD) device. The ECG signals of out-of-hospital cardiac arrest patients of cardiac aetiology were analysed just prior to, and immediately after, cardiopulmonary resuscitation (CPR) to assess the likelihood of successful defibrillation at these time points. The cardioversion outcome prediction (COP) measure previously developed by our group was used to quantify the probability of return of spontaneous circulation (ROSC) after counter-shock and was used as a measure of the efficacy of CPR. ⋯ However, a detailed statistical analysis carried out between the groups adjusted for pre-CPR value showed no significant difference between the two methods of CPR (p=0.20). Similarly, adjusting for length of CPR showed no significant difference between the groups. Secondary, subgroup analysis of the ECG according to the length of time for which CPR was performed showed that both types of CPR led to an increase in the likelihood of successful defibrillation after increasing durations of CPR, however results were less reliable after longer periods of continuous CPR.
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Randomized Controlled Trial Comparative Study
Comparison of two intraosseous infusion systems for adult emergency medical use.
The current guidelines of the European Resuscitation Council (ERC) stipulate that an intraosseous access should be placed if establishing a peripheral venous access for cardiopulmonary resuscitation (CPR) would involve delays. The aim of this study was therefore to compare a manual intraosseous infusion technique (MAN-IO) and a semi-automatic intraosseous infusion system (EZ-IO) using adult human cadavers as a model. ⋯ In an adult human cadaver model, the semi-automatic system was proven to be more effective. The EZ-IO gave more successful results, was associated with fewer technical complications, and is user friendlier.
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Controlled Clinical Trial
To see or not to see--better dispatcher-assisted CPR with video-calls? A qualitative study based on simulated trials.
Video communication through mobile telephone is now available in many parts of the world. We ask how mobile phone video-calls compares with traditional phone calls for dispatcher-assisted cardiopulmonary resuscitation (T-CPR). ⋯ Video communication can improve the dispatchers' understanding of the rescuer's situation, and the assistance they provide.
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The response of recurrent episodes of ventricular fibrillation (VF) to defibrillation shocks has not been systematically studied. We analyzed outcomes from countershocks delivered for VF during advanced life support (ALS) care of patients with out-of-hospital cardiac arrest. ⋯ Repeated refibrillation is common in patients with VF cardiac arrest. The likelihood of countershocks to terminate VF declines for repeated episodes of VF, yet shocks that terminate these episodes result increasingly in a sustained organized rhythm.