Resuscitation
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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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Randomized Controlled Trial
Can a flowchart improve the quality of bystander cardiopulmonary resuscitation?
Since the introduction of basic life support in the 1950s, on-going efforts have been made to improve the quality of bystander cardiopulmonary resuscitation (CPR). Even though bystander-CPR can increase the chance of survival almost fourfold, the rates of bystander initiated CPR have remained low and rarely exceed 20%. Lack of confidence and fear of committing mistakes are reasons why helpers refrain from initiating CPR. The authors tested the hypothesis that quality and confidence of bystander-CPR can be increased by supplying lay helpers with a basic life support flowchart when commencing CPR, in a simulated resuscitation model. ⋯ A chart provided at the beginning of resuscitation attempts improves quality of CPR significantly by decreasing HOT and increasing the participants' confidence when performing CPR. As reducing HOT is associated with improved outcome and positively impacting the helpers' confidence is one of the main obstacles to initiate CPR for lay helpers, charts could be utilised as simple measure to improve outcome in cardiopulmonary arrest.