Resuscitation
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Extra corporeal life support (ECLS) has been recently introduced in the treatment of refractory cardiac arrest (CA). Several studies have assessed the use of ECLS in refractory CA once the patients reach hospital. The time between CA and the implementation of ECLS is a major prognostic factor for survival. The main predictive factor for survival is ECLS access time. Pre hospital ECLS implementation could reduce access time. We therefore decided to assess the feasibility and safety of prehospital ECLS implementation (PH-ECLS) in a pilot study. ⋯ This pilot study suggests that PH-ECLS performed by non-surgeons is safe and feasible. Further studies are needed to confirm the time saved by this strategy and its potential effect on survival.
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Recent simplified guidelines recommend Hands-Only CPR for laypersons and efforts to educate the public of these changes have been made. We determined current knowledge of and willingness to perform Hands-Only CPR. ⋯ Less than one fifth of surveyed laypersons knew of Hands-Only CPR yet three quarters would be willing to perform Hands-Only CPR even on a stranger. Efforts to increase layperson education are required to enhance CPR performance.
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To improve our neonatal resuscitations we review video recordings of actual high-risk deliveries as an ongoing quality review process. In order to help identify and review errors that occurred during resuscitation we educated our resuscitation teams using crew resource management and in March 2009 developed a checklist to be used for potentially high-risk resuscitations. ⋯ The use of checklists during neonatal resuscitation was helpful in improving overall communication, and allowed for rapid identification of issues that need to be addressed by institutional leaders. There needs to be further evaluation of the utility and benefit of checklists for neonatal resuscitation. Based on our past and present experience we encourage the use of checklists for neonatal resuscitation teams.