Resuscitation
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Comparative Study
Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: a prospective computed tomography study.
Aneurysmal subarachnoid haemorrhage (SAH) is a relatively common cause of out-of-hospital cardiac arrest (OHCA). Early identification of SAH-induced OHCA with the use of brain computed tomography (CT) scan obtained immediately after resuscitation may help emergency physicians make therapeutic decision as quickly as they can. ⋯ Aneurysmal SAH causes OHCA more frequently than had been believed. Immediate brain CT scan may particularly be useful in excluding SAH-induced OHCA from thrombolytic trial enrollment, for whom the use of thrombolytics is contraindicated. The low VF incidence suggests that VF by itself may not be a common cause of SAH-induced OHCA.
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Comparative Study
Incidence of iatrogenic dyscarbia during mild therapeutic hypothermia after successful resuscitation from out-of-hospital cardiac arrest.
To investigate the incidence of iatrogenic dyscarbia in survivors of out-of-hospital cardiac arrest treated with induced mild hypothermia. We performed a retrospective cohort study of the ventilatory management based on blood gas analyses of patients resuscitated from prehospital cardiac arrest. In the pilot phase, we assessed the ventilatory management in the patients treated in one university hospital during a 4-year study period. ⋯ The incidence of hypo- or hyper-carbia (dyscarbia) was high (45%). This may predispose for serious derangements in the cerebral perfusion of the resuscitated patient. These results call for vigilance in adjustment of the ventilatory management to meet the needs of the patients treated with mild hypothermia.
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Comparative Study
A national survey of prevalence of cardiopulmonary resuscitation training and knowledge of the emergency number in Ireland.
The aim of this survey was to establish prevalence of cardiopulmonary resuscitation (CPR) training within the last 5 years and reasons preventing training and initiation of CPR in Ireland as well as awareness of the emergency numbers. ⋯ Previous Irish and American population targets for CPR training have been surpassed in Ireland in 2008. New internationally agreed targets are now required. Meanwhile older people and those in lower socio-economic groups should be targeted for training. Awareness of at least one emergency number is very high in Ireland. Some geographical variation was found and this should be studied further.
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Comparative Study
Development of a rapid, safe, fiber-optic guided, single-incision cricothyrotomy using a large ovine model: a pilot study.
We present a pilot study in which we use an ovine model to develop a rapid, safe cricothyrotomy technique using a Melker cuffed 5.0 cricothyrotomy catheter loaded over a fiberoptic stainless steel optical stylet. The technique requires a single incision. The stylet allows easy placement and facilitates visual, tactile, and transillumination confirmation of intratracheal placement. We recorded this process on video to facilitate the development of the procedure and to allow others to replicate it for further research or refinement. All devices used in this technique are currently employed in clinical practice. ⋯ The procedure is rapid, incorporates redundant safety features, and uses equipment increasingly available to anesthesiologists, emergency physicians, intensivists and surgeons. The promising outcome of this pilot study should be verified in a larger controlled, comparative trial.
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Comparative Study
Comparison of efficacy of pulsed biphasic waveform and rectilinear biphasic waveform in a short ventricular fibrillation pig model.
The waveform designs and their relative defibrillation efficacy of external biphasic waveforms may differ remarkably among manufacturers. In this study, we compared pulsed biphasic waveform (PBW) with rectilinear biphasic waveform (RBW) and their effects on terminating ventricular fibrillation (VF). ⋯ In the setting of this experiment, there was no difference in terms of defibrillation efficacy and myocardial injury related to the electrical shocks of the two waveforms.