Resuscitation
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To develop a new method to suppress the artefact generated by chest compressions during cardiopulmonary resuscitation (CPR) using only the frequency of the compressions as additional information. ⋯ For a similar sensitivity, we obtained better specificity than that reported for other methods, although still short of the values recommended by the American Heart Association. The results suggest that the CPR artefact can be accurately modelled using only the frequency of the compressions. This information could be easily acquired through the defibrillator's CPR help pads, with minimal hardware modifications.
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Neurologic prognostication after cardiac arrest relies on clinical examination findings derived before the advent of therapeutic hypothermia (TH). We measured the association between clinical examination findings at hospital arrival, 24, and 72 h after cardiac arrest in a modern intensive care unit setting. ⋯ GCS Motor score < or = 3 or < or = 2 at 24 or 72 h following cardiac arrest does not exclude survival or good outcome. However, absent pupil or corneal response at 72 h appears to exclude survival and good outcome.
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Video-based self-instruction (VSI) with a 24-min DVD and a personal resuscitation manikin solves some of the barriers associated with traditional basic life support (BLS) courses. No accurate assessment of the actual improvement in skills after attending a VSI course has been determined, and in this study we assess the skill improvement in laypersons undergoing VSI. ⋯ Untrained laypersons attending a 24 min DVD-based BLS course have a significantly improved BLS performance after 3 1/2-4 months compared to pre-test skill performance. Especially the total number of compressions improved and the hands-off time decreased.
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Following a CBRN incident attending medical personnel will be required to instigate life saving airway interventions whilst wearing CBRN-PPE. CBRN-PPE is known to adversely affect fine motor skill but little is known about whether the position of the patient compounds this problem. ⋯ the position of the patient is likely to be an independent factor when choosing to either intubate or insert a LMA whilst wearing the current NHS CBRN-PPE.
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To determine cardioversion doses of biphasic DC shock for paediatric atrial dysrhythmias. ⋯ In rounded doses, recommended initial external cardioversion doses are 0.5-1.0 J/kg and subsequently up to 2 J/kg, internal cardioversion doses are 0.5 J/kg.