Resuscitation
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Public awareness to cardiopulmonary resuscitation (CPR) and cardiac arrest is influenced by systemic factors including related policies and legislations in the community. Here, we describe and compare the results of the two nationwide CPR surveys in 2007 and 2011 examining public awareness and attitudes to bystander CPR in South Korea along with changes in nationwide CPR policies and systemic factors. ⋯ Changes in nationwide CPR policies and systemic factors affected citizens' awareness and willingness to perform bystander CPR. Additionally, applied dispatcher hands-only CPR and publicity increased public willingness to perform bystander CPR.
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Practice Guideline
Neurological prognostication after cardiac arrest--recommendations from the Swedish Resuscitation Council.
Cardiopulmonary resuscitation is started in 5000 victims of out-of-hospital cardiac arrest in Sweden each year and the survival rate is approximately 10%. The subsequent development of a global ischaemic brain injury is the major determinant of the neurological prognosis for those patients who reach the hospital alive. Induced hypothermia is a recommended treatment after cardiac arrest and has been implemented in most Swedish hospitals. ⋯ An expert group from the Swedish Resuscitation Council has reviewed the literature and made recommendations taking into account the effects of induced hypothermia and concomitant sedation. A delayed neurological evaluation at 72 h after rewarming is recommended for hypothermia treated patients. This evaluation should be based on several independent methods and the possibility of lingering pharmacological effects should be considered.
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Randomized Controlled Trial
Dispatchers impression plus Medical Priority Dispatch System reduced dispatch centre times in cases of out of hospital cardiac arrest. Pre-alert--a prospective, cluster randomized trial.
Dispatch centre processing times for out-of-hospital cardiac arrest or critically ill patients should be as short as possible. A modified 'pre-alert' dispatch workflow might be able to improve the processing time. ⋯ Dispatch times can effectively be reduced in cases of out-of-hospital cardiac arrest or critical ill patients with a 'pre-alert' dispatch workflow in combination with the Medical Priority Dispatch System protocol. This might play an important role in improving patient care.
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Randomized Controlled Trial
Should dispatchers instruct lay bystanders to undress patients before performing CPR? A randomized simulation study.
Dispatch-assisted CPR instructions frequently direct bystanders to remove a cardiac arrest patient's clothing prior to starting chest compressions. Removing clothing may delay compressions and it is uncertain whether CPR quality is influenced by the presence of clothing. We measured how instructions to remove clothing impacted the time to compressions and CPR performance by lay responders in a simulated arrest. ⋯ These findings suggest that eliminating instruction to remove a victim's clothing in dispatcher-assisted CPR will save time without compromising performance, which may improve survival from cardiac arrest.
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Observational Study
Validity of reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden.
To describe differences and similarities between reported and non-reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden. ⋯ Among 3198 cases of OHCA in three counties in Sweden, 800 (25%) were not reported prospectively by the EMS crews but were discovered retrospectively as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, having less frequently received bystander CPR but having a higher survival rate. Our data suggest that reports on OHCA from national quality registers which are based on prospectively recorded data may be influenced by selection bias.