Resuscitation
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Comparative Study
Capnography and chest-wall impedance algorithms for ventilation detection during cardiopulmonary resuscitation.
Hyperventilation is both common and detrimental during cardiopulmonary resuscitation (CPR). Chest-wall impedance algorithms have been developed to detect ventilations during CPR. However, impedance signals are challenged by noise artifact from multiple sources, including chest compressions. Capnography has been proposed as an alternate method to measure ventilations. We sought to assess and compare the adequacy of these two approaches. ⋯ Both the impedance and capnography-based algorithms underestimated the ventilation rate. Reliable ventilation rate determination may require a novel combination of multiple algorithms during resuscitation.
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Randomized Controlled Trial
Distribution of pre-course BLS/AED manuals does not influence skill acquisition and retention in lay rescuers: a randomised study.
The present study aims to investigate whether the distribution of the Basic Life Support and Automated External Defibrillation (BLS/AED) manual, 4 weeks prior to the course, has an effect on skill acquisition, theoretical knowledge and skill retention, compared with courses where manuals were not distributed. ⋯ The present study shows that distribution of BLS/AED manuals 1 month prior to the course has no effect on theoretical knowledge, skill acquisition and skill retention in laypeople.
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Comparative Study
Detrended fluctuation analysis predicts successful defibrillation for out-of-hospital ventricular fibrillation cardiac arrest.
Repeated failed shocks for ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OOHCA) can worsen the outcome. It is very important to rapidly distinguish between early and late VF. We hypothesised that VF waveform analysis based on detrended fluctuation analysis (DFA) can help predict successful defibrillation. ⋯ The VF waveform analysis based on DFA could help predict first-shock defibrillation success in patients with OOHCA. The clinical utility of the approach deserves further investigation.
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Total liquid ventilation (TLV) with cooled perfluorocarbons has been demonstrated to induce an ultrafast cardioprotective cooling in rabbits. However, it remains unknown whether this technically challenging strategy would be actually more potent than a conventional external cooling after a prolonged ischemia inducing transmural myocardial infarction. ⋯ Cooling induced by TLV afforded a potent cardioprotection and prevented transmural infarction following prolonged and severe ischemia, even when started later than a surface cooling in rabbits.
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Patient history and physical examination are widely accepted as cornerstones of diagnosis in modern medicine. We aimed to assess the value of individual historical and examination findings for diagnosing acute myocardial infarction (AMI) and predicting adverse cardiac events in undifferentiated Emergency Department (ED) patients with chest pain. ⋯ Our results challenge many widely held assertions about the value of individual symptoms and signs in ED patients with suspected acute coronary syndromes. Several 'atypical' symptoms actually render AMI more likely, whereas many 'typical' symptoms that are often considered to identify high-risk populations have no diagnostic value.