Resuscitation
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Randomized Controlled Trial Multicenter Study Comparative Study
Predicting non-cardiac aetiology: a strategy to allocate rescue breathing during bystander CPR.
Optimal care for out-of hospital cardiac arrest (OHCA) patients may depend on the underlying aetiology of OHCA. Specifically chest compression only bystander CPR may provide greater benefit among those with cardiac aetiology and chest compressions plus rescue breathing may provide greater benefit among those with non-cardiac aetiology. The aim of this study was to generate a simple predictor model to identify OHCA patients with non-cardiac aetiology in order to accurately allocate rescue breathing. ⋯ The results highlight the challenge of accurately identifying non-cardiac aetiology by characteristics that could be consistently used to allocate bystander rescue breathing.
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Randomized Controlled Trial Comparative Study
Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins.
Current European Resuscitation Council (ERC) guidelines recommend intraosseous (IO) vascular access, if intravenous (IV) access is not readily available. Because central venous catheterisation (CVC) is an established alternative for in-hospital resuscitation, we compared IO access versus landmark-based CVC in adults with difficult peripheral veins. ⋯ IO vascular access is a reliable bridging method to gain vascular access for in-hospital adult patients under resuscitation with difficult peripheral veins. Moreover, IO access is more efficacious with a higher success rate on first attempt and a lower procedure time compared to landmark-based CVC.
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Randomized Controlled Trial Comparative Study
Evaluation of a novel paediatric self-inflating bag to improve accuracy of tidal volumes delivered during simulated advanced paediatric resuscitation.
The aim of the study is to compare the accuracy of manually delivered target tidal volumes (TVs) with the conventional paediatric self-inflating bags (CPBs) versus the novel paediatric self-inflating bags (NPBs) during simulated advanced paediatric resuscitation. ⋯ NPB is useful as a ventilation device for the accurate delivery of TV to small children of varying weights.
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Randomized Controlled Trial Comparative Study
Quality controlled manual chest compressions and cerebral oxygenation during in-hospital cardiac arrest.
The quality of cardiopulmonary resuscitation (CPR) is associated with the rate of return of spontaneous circulation (ROSC) during human cardiac arrest. Current advances in defibrillator technology enable measurement of CPR quality during resuscitation, but it is not known whether this is directly reflected in cerebral oxygenation. In this descriptive study we aimed to evaluate whether the quality of feedback-monitored CPR during in-hospital cardiac arrest is reflected in near infrared frontal cerebral spectroscopy (NIRS). ⋯ High quality CPR was not significantly reflected in cerebral oxygenation as quantified using NIRS. Even after ROSC and subsequent significant increase in cerebral oxygenation, rSO(2) readings were below previously suggested threshold of cerebral ischaemia. Improving CPR technique after an episode of low quality CPR did not significantly increase rSO(2).