Resuscitation
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Review Meta Analysis
Audiovisual feedback device use by health care professionals during CPR: a systematic review and meta-analysis of randomised and non-randomised trials.
A systematic appraisal of the literature to determine if audiovisual feedback devices can improve CPR quality delivered by health care practitioners (HCPs) and/or survival outcomes following cardiac arrest. ⋯ In both manikin and human studies, feedback during resuscitation can result in rescuers providing CC parameters closer to recommendations. There is no evidence that this translates into improved patient outcomes. The reason for this is not yet evident and further patient centered research is warranted.
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Randomized Controlled Trial Comparative Study
A randomised control trial of prompt and feedback devices and their impact on quality of chest compressions-a simulation study.
This study aims to compare the effect of three CPR prompt and feedback devices on quality of chest compressions amongst healthcare providers. ⋯ CPR feedback devices vary in their ability to improve performance. In this study the pressure sensor device improved compression depth, whilst the accelerometer device reduced it and metronome had no effect.
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Multicenter Study
Implementation Trial of the Basic Life Support Termination of Resuscitation Rule: Reducing the Transport of Futile Out-Of-Hospital Cardiac Arrests.
The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given, and prior studies have suggested the transport rate should fall to 37%. ⋯ This implementation trial confirmed the accuracy of the BLS TOR rule in identifying futile out-of-hospital cardiac arrest (OHCA) resuscitations, significantly reduced the transport rate of futile OHCA and most providers and physicians were comfortable following the rule's recommendations.
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Significant amount of data on the incidence and outcome of out-of-hospital and in-hospital cardiac arrest have been published. Cardiac arrest occurring in the intensive care unit has received less attention. ⋯ At present data on intensive care unit cardiac arrest is quite limited and originates mostly from retrospective single center studies. The quality of data overall seems to be poor and thus focused prospective multi-center studies are needed.
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Randomized Controlled Trial
Basic Life Support trained nurses ventilate more efficiently with laryngeal mask Supreme than with facemask or laryngeal tube Suction-Disposable-a prospective, randomized clinical trial.
In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation. ⋯ After one hour of introductory training, nurses were able to use LMA-S more effectively than facemask and LTS-D. High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices. High-level trials are needed to confirm these results in cardiac arrest patients.