Resuscitation
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Randomized Controlled Trial
The "Resus:Station": the use of clinical simulations in a randomised crossover study to evaluate a novel resuscitation trolley.
Inadequately designed equipment has been implicated in poor efficiency and critical incidents associated with resuscitation. A novel resuscitation trolley (Resus:Station) was designed and evaluated for impact on team efficiency, user opinion, and teamwork, compared with the standard trolley, in simulated cardiac arrest scenarios. ⋯ We conclude that in this simulated environment, the new design of trolley is safe to use, and has the potential to improve efficiency at a resuscitation attempt.
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Multicenter Study
The factors associated with successful paediatric endotracheal intubation on the first attempt in emergency departments: a 13-emergency-department registry study.
We investigated which factors are associated with successful paediatric endotracheal intubation (ETI) on the first attempt in emergency department (EDs) from multicentre emergency airway registry data. ⋯ The intubator's specialty was the major factor associated with FPS in emergency department paediatric ETI, The overall ETI FPS rate among paediatric patients was 67.6%, but the EM physicians had a FPS rate of 74.4%. A well structured airway skill training program, and more actively using the RSI method are important and this could explain this differences.
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Survival data for out-of-hospital cardiac arrest (OHCA) victims initially in PEA or asystole who convert to a shockable rhythm during attempted resuscitation, relative to an initial shockable rhythm, have never been previously reported. This study was done to assess OHCA outcomes among a large cohort of adults in the CARES dataset stratified by three rhythm categories: initial shockable (IS), converted shockable (CS), and never shockable (NS). ⋯ After OHCA, the survival rate for CS victims is significantly lower than for IS patients. These findings suggest that CS and IS are different entities and that alternatives to existing resuscitation algorithm tailored to patients with CS should be investigated.
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According to Norwegian law, an autonomous patient has the right to refuse life-prolonging treatment. If the patient is not defined as dying, however, health personnel are obliged to instigate life-saving treatment in an emergency situation even against the patient's wishes. The purpose of this study was to investigate how doctors' attitudes and knowledge agree with these legal provisions, and how the statutory provision on emergency situations influences the principle of patient autonomy for severely ill, but not dying, patients. ⋯ The answers indicate that the respondents include patients' refusal in an overall clinical judgement, and interpret patients' right to decline life-saving treatment in different ways. This may reflect the complex legal situation in Norway regarding patient autonomy with respect to the right of severely ill, but not dying, patients' right to decline acute life-saving treatment.
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Infusion of bone marrow mesenchymal stem cells (MSCs) improves myocardial function following myocardial infarction (MI). The mechanisms, however, remain controversial. This study was to investigate changes of MSCs in vivo after administration into myocardial infarcted rats. Our hypothesis was that MSCs might differentiate into contractile myocytes and improve myocardial function in vivo. ⋯ MSCs can differentiate into beating cardiomyocytes in a rat model of MI and improve myocardial function.