Resuscitation
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Multicenter Study Comparative Study
Practice variability among the EMS systems participating in Cardiac Arrest Registry to Enhance Survival (CARES).
To describe the demographic, organizational and provider characteristics of the Emergency Medical Services (EMS) agencies participating in the Cardiac Arrest Registry to Enhance Survival (CARES). ⋯ Differences were observed between the EMS agencies participating in CARES. The clinical impact of these observed differences in agency and provider characteristics on OHCA outcomes deserves study.
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Multicenter Study Comparative Study
Helping Babies Breathe: global neonatal resuscitation program development and formative educational evaluation.
To develop an educational program designed to train health care providers in resource limited settings to carry out neonatal resuscitation. We analyzed facilitator and learner perceptions about the course, examined skill performance, and assessed the quality of instruments used for learner evaluation as part of the formative evaluation of the educational program Helping Babies Breathe. ⋯ Participants in a program for neonatal resuscitation in resource-limited settings demonstrated high satisfaction, high self-efficacy and gains in knowledge and skills. Mastery of ventilation skills and integration of skills into case management may not be achievable in the classroom setting without additional practice, continued learning, and active mentoring in the workplace. These findings were used to revise program structure, materials and assessment tools.
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To describe the advancement of Intraosseous (IO) infusion in the spectrum of resuscitative protocols and to provide a systematic review on currently used semi-automatic IO infusion devices. The specific question addressed was: "In patients undergoing resuscitation, does the use of semi-automatic IO infusion devices compared to manual needles influence IO placement success rate, time for IO placement, and ease-of-use and user preference?" ⋯ Only a few studies compared the performance of different types of IO infusion devices, most of them have a low level of evidence. These studies suggested a superiority of the battery-powered IO driver over manual needles, and other semi-automatic IO infuson devices.
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Successful resuscitation after cardiac arrest is typically associated with cerebral and myocardial ischemia/reperfusion (I/R)-injury. Recently, we have demonstrated effects of therapeutic hypothermia (HT) and postconditioning with the volatile anesthetic sevoflurane (SEV) on I/R-mediated mechanisms in the heart and brain [Meybohm et al., PLoS One, 2009; Meybohm et al., Crit Care, 2010]. As the intestine is also highly susceptible to I/R-injury, we investigated the influence of HT and SEV on intestinal I/R-mediated events induced by cardiac arrest and successful resuscitation. ⋯ HT and postconditioning with SEV influence the expression and activity of several small intestinal proteins that are possibly involved in intestinal I/R-mediated events following successful cardiopulmonary resuscitation.