Resuscitation
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Randomized Controlled Trial Multicenter Study
Impact of essential surgical skills with an emphasis on emergency maternal, neonatal and child health training on the practice of doctors: a cluster randomised controlled trial in Pakistan.
Majority of studies on evaluation of emergency management courses have focused on outcomes such as knowledge and skills demonstrated in non-clinical or traditional testing manner. Such surrogate outcomes may not necessarily reflect vital changes in practice. The aim of this study was to determine if and to what extent, specific training in the management of life threatening emergencies resulted in an increased in compliance with established care guidelines of doctors working in the emergency departments of public sector hospitals in Pakistan. ⋯ 5-day training of ESS-EMNCH significantly increased the compliance with established care guidelines of doctors during their management of life threatening emergency episodes in the public sector hospitals in Pakistan.
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Randomized Controlled Trial
Hands-off time during insertion of six airway devices during cardiopulmonary resuscitation: a randomised manikin trial.
Cardiopulmonary resuscitation (CPR) guidelines recommend limiting interruptions of chest compressions because prolonged hands-off (i.e., non-compression) time compromises tissue perfusion. 2010 European Resuscitation Council guidelines suggest that chest compressions should be paused less than 10 s during airway device insertion. ⋯ Supraglottic devices appear to be a reasonable emergency airway management strategy, even for inexperienced personnel.
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Comparative Study
The impact of backboard size and orientation on sternum-to-spine compression depth and compression stiffness in a manikin study of CPR using two mattress types.
To explore how backboard orientation and size impact chest compressions during cardiopulmonary resuscitation (CPR). ⋯ The effect of backboard size on chest compression (CC) performance during CPR was found to be significant with the larger backboard producing deeper chest compressions and higher back support stiffness than the smaller backboard. The impact of backboard orientation was found to depend on the size of the backboard and type of mattress used. Clinicians should be aware that although a smaller backboard may be easier for rescuers to manipulate, it does not provide as effective back support or produce as deep chest compressions as a larger backboard.
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Public access defibrillation can improve survival but is involved in only a small fraction of out-of-hospital cardiac arrest. One approach to increase involvement is to couple emergency dispatch with mapping technology to identify public access automated external defibrillators (AEDs) that are on-site or nearby. ⋯ A working link between emergency dispatch and an AED registry may provide an opportunity to improve resuscitation.