Resuscitation
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Multicenter Study Controlled Clinical Trial
A prospective controlled trial of the effect of a multi-faceted intervention on early recognition and intervention in deteriorating hospital patients.
To determine whether the introduction of a multi-faceted intervention (newly designed ward observation chart, a track and trigger system and an associated education program, COMPASS) to detect clinical deterioration in patients would decrease the rate of predefined adverse outcomes. ⋯ The introduction of a multi-faceted intervention to detect clinical deterioration may benefit patients through increased monitoring of vital signs and the triggering of a medical review following an episode of clinical instability.
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Editorial Comment
Continuous chest compression CPR preferred for primary cardiac arrest.
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Avalanche resuscitation will save lives if focussed on victims that have the potential to survive. The purpose of this systematic review was to examine 4 critical prognostic factors for burial victims in cardiac arrest. ⋯ After 35 min of burial, or where the core temperature is less than 32 degrees C, a patent airway is associated with survival to hospital discharge. A serum potassium of less than 7 mmol/L may be a valuable indicator for survival when other indicators are unclear. These findings should modify the current avalanche resuscitation scheme.
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Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR. ⋯ The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training.
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Randomized Controlled Trial Comparative Study
Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR.
Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. ⋯ Healthcare providers required 0.6s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique.