Resuscitation
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Review Meta Analysis Comparative Study
The effect of hyperoxia following cardiac arrest - A systematic review and meta-analysis of animal trials.
There are conflicting findings from observational studies regarding the nature of the association between hyperoxia and risk of mortality in patients admitted to intensive care following cardiac arrest. This systematic review and meta-analysis evaluates animal data investigating the effect of administration of high concentrations of oxygen following cardiac arrest on neurological outcome and the clinical applicability of this data. ⋯ The administration of 100% oxygen therapy is associated with worse neurological outcome than lower oxygen concentrations in animal models of cardiac arrest. However, due to limitations in study design and poor generalisability of the animal models to the situation of post cardiac arrest resuscitation in humans, the clinical applicability of this data is uncertain.
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There is an increasing interest in human factors within the healthcare environment reflecting the understanding of their impact on safety. The aim of this paper is to explore how human factors might be taught on resuscitation courses, and improve course outcomes in terms of improved mortality and morbidity for patients. The delivery of human factors training is important and this review explores the work that has been delivered already and areas for future research and teaching. ⋯ Four strategies for improving human factors training are discussed: team dynamics (including team membership and leadership behaviour), the influence of stress, debriefing, and conflict within teams. This review illustrates how human factor training might be integrated further into life support training without jeopardising the core content and lengthening the courses.
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Review Historical Article
Airway manoeuvres to achieve upper airway patency during mask ventilation in newborn infants - An historical perspective.
Maintenance of upper airway patency remains a cornerstone of adequate airway management. Although various opening manoeuvres are recommended by neonatal resuscitation guidelines, none of these have been well evaluated in newly born infants. The aim of this article was to review the available literature about airway opening manoeuvres in newborn infants. ⋯ During mask PPV, jaw thrust appears to be more effective in achieving a patent upper airway and might help to reduce airway obstruction. The additional application of chin lift might reduce leak during mask ventilation. However given the lack of available data these conclusions remains speculative and further research in this area is required.