Resuscitation
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Some cardiac phenomena demonstrate temporal variability. We evaluated temporal variability in out-of-hospital cardiac arrest (OHCA) frequency and outcome. ⋯ There is temporal variability in OHCA frequency and outcome. Underlying patient, EMS system and environmental factors need to be explored to offer further insight into these observed patterns.
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Randomized Controlled Trial Clinical Trial
Manual ventilation devices in neonatal resuscitation: tidal volume and positive pressure-provision.
Excessive peak inspiratory pressures (PIP) and high tidal volumes (Vt) during manual ventilation can be detrimental to the neonatal lung. We compared the influence of different manual ventilation devices and individual professional experience on the extent of applied Vt and PIP in simulated neonatal resuscitation. ⋯ Use of T-piece devices guarantees reliable and constant Vt and PIP provision, irrespective of individual, operator dependent variables. Methods to measure and to avoid excessive tidal volumes in neonatal resuscitation need to be developed.
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Although strategic use of public access defibrillation (PAD) can improve cardiac arrest survival, little is known about temporal trends in PAD deployment and use or how PAD affects the role of emergency medical services (EMS). We sought to determine the frequency, circumstances, and time trends of PAD AED and determine implications of PAD use for EMS providers. ⋯ PAD AED increased over time. Most PAD patients were pulseless upon EMS arrival and required basic and advanced resuscitation care by EMS; yet most subsequently achieved spontaneous circulation.
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Randomized Controlled Trial
Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India.
Data on the efficacy of the simulation and multimedia teaching modalities is limited, particularly in developing nations. This study evaluates the effectiveness of simulator and multimedia educational tools in India. ⋯ Simulation and multimedia educational tools were effective and may provide significant additive benefit compared to reading alone. Indian students enjoyed learning via these modalities.
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Emergency Medical Services (EMS) systems play key roles in the rapid identification and treatment of critical illness such as trauma, myocardial infarction and stroke. EMS often provides care for sepsis, a life-threatening sequelae of infection. In this study of Emergency Department patients admitted to the hospital with an infection, we characterized the patients receiving initial care by EMS. ⋯ EMS provides initial care for over one-third of ED infection patients, including the majority of patients with severe sepsis, septic shock, and those who ultimately die. EMS systems may offer important opportunities for advancing sepsis diagnosis and care.