Resuscitation
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The incidence rate of out-of-hospital cardiac arrest (OHCA) among infants is high; however, little is known about effective life-support for this group. Thus, we examined factors related to 1-month survival after OHCA among infants. ⋯ The probability of survival after OHCA in infants may be improved by a bystander witnessing the arrest and providing the rescue breathing at the first sight of arrest.
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Rapid Response Teams (RRTs) have been introduced into at least 60% of Intensive Care Unit (ICU) - equipped Australian hospitals to review deteriorating ward patients. Most studies have assessed their impact on patient outcome and less information exists on team composition or aspects of their calling criteria. ⋯ Our findings imply the likelihood of significant practice variation in relation to RRT composition, staff skill set and activation criteria between hospitals. We recommend improved resourcing of RRTs, training of the team members, and consideration for improved standardisation of calling criteria across institutions.
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To study the changes of brain water diffusion and cerebral haemodynamics of cortical areas using magnetic resonance imaging (MRI) in canine models of cardiac arrest (CA) and restoration of spontaneous circulation (ROSC). The secondary study objective was to evaluate whether MRI can be used to observe haemodynamic disorders in brain microcirculation. ⋯ These data provide the evidence that early MRI can be used to observe acute haemodynamic disorders in brain microcirculation in a canine model of cardiac arrest.
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Defibrillators are used to treat many thousands of people each year using very high voltages, but, despite this, reported injuries to rescuers are rare. Although even a small number of reported injuries is not ideal, the safety record of the defibrillator using the current protocol is widely regarded as being acceptable. There is increasing evidence that clinical outcome is significantly improved with continuous chest compressions, but defibrillation is a common cause of interruptions; even short interruptions, such as those associated with defibrillation, may detrimentally affect the outcome. ⋯ Clearly any deviation from accepted practice should only be undertaken following careful consideration of the risks and benefits to the patient, rescuers and others. This review summarises the physical principles of electrical risk and identifies ways in which these could be managed. In doing so, it is hoped that in future it may be possible to deliver continuous and safe manual chest compressions during defibrillator discharge in order to improve patient outcome.