Resuscitation
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Comparative Study
Post-resuscitation care at the emergency department with critical care facilities--a length-of-stay analysis.
An emergency department providing critical care will have an effect on outcome and intensive-care-units' resources by avoiding unnecessary or futile intensive-care admissions and thereby save hospital expenses. The study focussed on this result. ⋯ An emergency department with critical care prevents admissions to intensive care units in 28% of patients with out-of-hospital cardiac arrest. It saves intensive-care-unit resources and shortens length of stay for comatose out-of-hospital cardiac-arrest survivors, regardless of their outcome.
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Comparative Study
A comparison of metropolitan vs rural major trauma in Western Australia.
Metropolitan and rural Western Australia (WA) major trauma transport times are extremely different. We compared outcomes from these different systems of care. ⋯ There is more than double the risk of major trauma death in rural and remote WA. However, if a major trauma patient survives to be retrieved to Perth by the RFDS, then mortality outcomes are equivalent to the metropolitan area.
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Comparative Study
A proposed decision-making guide for the search, rescue and resuscitation of submersion (head under) victims based on expert opinion.
There is some confusion, and consequent variation in policy, between the agencies responsible for the search, rescue and resuscitation of submersion victims regarding the likelihood of survival following a period of submersion. The aim of this work was to recommend a decision-making guide for such victims. This guidance was arrived at by a review of the relevant literature and specific case studies, and a "consensus" meeting on the topic. ⋯ Of these, only water temperature and duration are sufficiently clear to form the basis of guidance in this area. It is concluded that if water temperature is warmer than 6°C, survival/resuscitation is extremely unlikely if submerged longer than 30 min. If water temperature is 6°C or below, survival/resuscitation is extremely unlikely if submerged longer than 90 min.
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Multicenter Study Comparative Study
Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients.
We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions. ⋯ Even after adjusting for confounding factors, admission day (weekday vs. weekend/holiday) had no effect on 1-month survival or neurologically favourable 1-month survival. In contrast, daytime admission was associated with significantly better outcomes than nighttime admissions.
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To describe the consensus on science pertaining to resuscitation of the pregnant patient. ⋯ Usual defibrillation dosages are likely appropriate in pregnancy. Perimortem cesarean section is an intervention which is rarely done within 5 min to optimize maternal salvage from cardiac arrest. Chest compressions in left lateral tilt are less forceful compared to the supine position.