Resuscitation
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Comparative Study
Comparing the systolic blood pressure (SBP) and pulse rate (PR) in injured children with and without traumatic brain injury.
Following evidence that injured children have higher systolic blood pressures (SBP) than similar-aged resting uninjured children, we investigate whether the initial cardiovascular physiology differs between forms of injury. ⋯ Although injured children remain hypertensive as compared to resting norms, we have seen no difference in the initial systolic blood pressure of moderately and severely injured children with and without traumatic brain injury. The relative bradycardia in the younger children appears to be an early sign of a severe traumatic brain injury.
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Comparative Study
Scandinavian pre-hospital physician-manned Emergency Medical Services--same concept across borders?
In Scandinavia, scattered populations and challenging geographical and climatic conditions necessitate highly advanced medical treatment by qualified pre-hospital services. Just like every other part of the health care system, the specialized pre-hospital EMS should aim to optimize its resource use, and critically review as well as continuously assess the quality of its practices. This study aims to provide a comprehensive profile of the pre-hospital, physician-manned EMS in the Scandinavian countries. ⋯ This survey documented several significant similarities among pre-hospital physician-staffed EMS systems in Scandinavia. Although medical data registration is currently under-developed, Scandinavian physician-manned EMS is a feasible arena for future multi-centre research.
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Comparative Study
Discriminating the effect of accelerated compression from accelerated decompression during high-impulse CPR in a porcine model of cardiac arrest.
Piston based mechanical chest compression devices deliver compressions and decompressions in an accelerated pattern, resulting in superior haemodynamics compared to manual compression in animal studies. The present animal study compares haemodynamics during two different hybrid compression patterns to a standard compression pattern resembling that of modern mechanical chest compression devices. ⋯ Both cardiac and cerebral perfusion benefited from accelerated decompression, while accelerated compression did not improve haemodynamics. The evolution of mechanical CPR is dependent on further research on mechanisms generating forward blood flow during external chest compressions.
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Comparative Study
Feasibility and safety of combined percutaneous coronary intervention and therapeutic hypothermia following cardiac arrest.
Mild therapeautic hypothermia (MTH) has been associated with cardiac dysrhythmias, coagulopathy and infection. After restoration of spontaneous circulation (ROSC), many cardiac arrest patients undergo percutaneous coronary intervention (PCI). The safety and feasibility of combined MTH and PCI remains unclear. This is the first study to evaluate whether PCI increases cardiac risk or compromises functional outcomes in comatose cardiac arrest patients who undergo MTH. ⋯ Percutaneous coronary intervention seems to be feasible when combined with MTH, and is not associated with increased cardiac or neurological risk.
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Survival after out-of-hospital cardiac arrest (OHCA) depends on a well functioning Chain of Survival. We wanted to assess if targeted attempts to strengthen the weak links of our local chain; quality of advanced life support (ALS) and post-resuscitation care, would improve outcome. ⋯ Survival after OHCA was increased after improving weak links of our local Chain of Survival, quality of ALS and post-resuscitation care.