Resuscitation
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Therapeutic hypothermia, also known as targeted temperature management (TTM), improves clinical outcomes in patients resuscitated from cardiac arrest. Hyperthermia after discontinuation of active temperature management ("rebound pyrexia") has been observed, but its incidence and association with clinical outcomes is poorly described. We hypothesized that rebound pyrexia is common after rewarming in post-arrest patients and is associated with poor neurologic outcomes. ⋯ Rebound pyrexia occurred in 41% of TTM-treated post-arrest patients, and was not associated with lower survival to discharge or worsened neurologic outcomes. However, among patients with pyrexia, higher maximum temperature (>38.7°C) was associated with worse neurologic outcomes among survivors to hospital discharge.
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Comparative Study
Forensic analysis of crib mattress properties on pediatric CPR quality--can we balance pressure reduction with CPR effectiveness?
Single mode, pressure reduction (PR) crib mattresses are increasingly employed in hospitals to prevent skin injury and infection. However, single mode PR mattresses risk large mattress deflection during CPR chest compressions, potentially leading to inadequate chest compressions. ⋯ Chest compressions delivered on dual mode pressure reduction crib mattresses resulted in substantially smaller mattress deflection compared to single mode pressure reduction mattresses. Skin pressure reduction qualities of dual mode pressure reduction crib mattress were maintained. We recommend that backboards continue to be used in order to mitigate mattress deflection during CPR on soft mattresses.
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Randomized Controlled Trial
The benefits of a simplified method for CPR training of medical professionals: a randomized controlled study.
We developed and tested a training method for basic life support incorporating defibrillator feedback during simulated cardiac arrest (CA) to determine the impact on the quality and retention of CPR skills. ⋯ A simplified 2h training method using audiovisual feedback combined with quantitative review of CPR performance improved CPR quality and retention of these skills.
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Comparative Study
The analysis of efficacy for AutoPulse™ system in flying helicopter.
The helicopter emergency medical service (HEMS) was introduced in Japan in 2001, and some cardiopulmonary arrest (CPA) patients are transported using this service. However, it is difficult to maintain continuous and effective manual cardiopulmonary resuscitation (CPR) in flying helicopters. To overcome this problem, the AutoPulse™ system, automated mechanical CPR devices, was induced. We conducted a retrospective study to clarify the efficacy of AutoPulse™ on CPA patients in flying helicopters. ⋯ The present study demonstrates that the use of AutoPulse™ in flying helicopters was significantly effective for the ROSC in CPA patients. The use of automated chest compression devices such as AutoPulse™ might be recommended at least for CPA patients transported by helicopters.
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Compare and contrast rapid response team (RRT) calls to patients with, and those without, a pre-existing not for resuscitation (NFR) order. ⋯ RRT calls to patients with pre-existing NFR orders are not uncommon. The worried criterion is more often the trigger, they have abnormal respiratory observations at time of call, a similar level of intervention, less likely to be admitted to the ICU and more likely to be documented not for further RRT calls.