Resuscitation
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An increased number of rescuers may improve the survival rate from out-of-hospital cardiac arrests (OHCAs). The majority of OHCAs occur at home and are handled by family members. ⋯ In summary, an increased number of rescuers improves the outcomes of OHCAs. However, this beneficial effect is absent in OHCAs that occur at home.
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Multicenter Study
Responding to medical emergencies: system characteristics under examination (RESCUE). A prospective multi-site point prevalence study.
To determine the point-prevalence of patients fulfilling hospital-specific Medical Emergency Team (MET) criteria and their subsequent outcomes. ⋯ Approximately 1 in 30 hospitalised patients fulfilled MET criteria during data collection. The presence of MET criteria was associated with increased hospital, 30 and 60 day mortality, although much of this increased mortality seemed to be due to issues around end-of-life care. Despite ward manager notification, subsequent MET activation occurred infrequently in these hospitals with established METs. Further research is needed to assess factors that influence staff initiation of a MET call.
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Comparative Study
Crystalloid vs. hypertonic crystalloid-colloid solutions for induction of mild therapeutic hypothermia after experimental cardiac arrest.
To compare cerebral and hemodynamic consequences of different volumes of cold acetated Ringer's solution or cold hypertonic saline dextran administered in order to achieve mild hypothermia after cardiac arrest (CA) in a pig model of experimental cardiopulmonary resuscitation (CPR). ⋯ No statistical differences were observed between the hypothermic groups in the time to achieve mild hypothermia. Although inclusion of cold hypertonic crystalloid-colloidal solutions in the early resuscitation after ROSC may be more effective than cold crystalloids in reducing brain edema, this study demonstrates that mild hypothermia induced with small volumes of cold hypertonic crystalloid-colloids is less as effective as crystalloid's induced hypothermia in mitigating brain injury after cardiac arrest.
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Smartphones are widely used by physicians, but their effectiveness in improving teaching of clinical skills is not known. The aim of this study was to determine if pre procedural use of a smartphone neonatal intubation instructional application (NeoTube) improves trainee knowledge and enhances procedural skills performance in newborn intubation. ⋯ Bedside use of smartphones can enhance both knowledge of newborn intubation and improves procedural performance, including reducing the time to successfully intubate. Smartphones may have a useful role in bringing procedural skills training closer to the bedside.