Resuscitation
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Multicenter Study Clinical Trial
Chest compression quality variables influencing the temporal development of ROSC-predictors calculated from the ECG during VF.
Predictive measures that reflect the probability of return of spontaneous circulation (ROSC) if the patient is defibrillated can be calculated from the electrocardiogram during ventricular fibrillation (VF) and ventricular tachycardia (VT). It has not been studied how the quality of chest compressions affect the development of such ROSC predictors. ⋯ Using MS as an indicator of the state of the myocardium, force-based compression quality variables are better indicators of efficient CPR than compression depth. A novel indicator termed residual heart force gives the best correlation with observed trends in MS.
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Randomized Controlled Trial
Is there any room for shortening hands-off time further when using an AED?
Automated external defibrillators (AEDs) play a very important role in out-of-hospital cardiopulmonary resuscitation (CPR). The mandatory hands-off time imposed by current AEDs is not short enough to bring about the full benefits of rapid defibrillation with an AED into light. The aim of this study is to examine whether a change in the process of charging the capacity and removing explanations from the prompts of the AEDs shortens hands-off time. ⋯ Full precharging of the capacitor and exclusion of explanations from the voice prompts of AEDs can shorten the hands-off time in both 1 and 2-rescuer CPR.
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Comparative Study
Emergency cricothyrotomy-a comparative study of different techniques in human cadavers.
Emergency cricothyrotomy is the final lifesaving option in "cannot intubate-cannot ventilate" situations. Fast, efficient and safe management is indispensable to reestablish oxygenation, thus the quickest, most reliable and safest technique should be used. Several cricothyrotomy techniques exist, which can be grouped into two categories: anatomical-surgical and puncture. ⋯ In inexperienced health care personnel, anatomical-surgical techniques showed a higher success rate, a faster tracheal tube insertion time and a lower complication rate compared with puncture techniques, suggesting that they may be the techniques of choice in emergencies.
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Patients who survive after suicidal hanging attempts suffer from transient brain ischaemia. Morbidity and mortality is high, and no specific therapy is available. Hypothermia attenuates ischaemic brain damage and has become standard care in comatose survivors of cardiac arrest; therapeutic hypothermia may thus be useful for near-hanging victims as well. ⋯ No randomised, controlled trial for treatment of near-hanging victims has been published. No conclusions could be drawn regarding treatment effects of hypothermia in this survey, but in the absence of better evidence, it seems reasonable to consider hypothermia treatment in all comatose near-hanging victims.
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Randomized Controlled Trial
Defibrillation and the quality of layperson cardiopulmonary resuscitation-dispatcher assistance or training?
To examine whether basic life support-defibrillation (BLS-D) training of laypersons enhances the speed of defibrillation and the quality of cardiopulmonary resuscitation (CPR) during a simulated ventricular fibrillation scenario compared with a situation where the care provider has no previous BLS-D training but receives dispatcher assistance with the use of an automated external defibrillator (AED) and the performance of CPR. ⋯ Training improved the quality of mouth-to-mouth ventilation performed by laypersons but had only a minor effect on defibrillation and the quality of compressions.