Resuscitation
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Emergency medical service (EMS) practitioners' experience and exposure to out-of-hospital cardiac arrest (OHCA) and advanced life support (ALS) procedures could be an important factor in procedural success and patient survival. We systematically reviewed the literature to examine these associations. ⋯ There is no clear evidence of an association with EMS practitioner career experience or exposure to OHCA cases and ALS procedures, with the exception of exposure to ETI and successful placement. However, most studies in this field had substantial risk of bias. Therefore, further studies are required before any definitive conclusions can be drawn.
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Randomized Controlled Trial Comparative Study
Changes to DA-CPR instructions: Can we reduce time to first compression and improve quality of bystander CPR?
Dispatcher-assisted CPR (DA-CPR) can increase rates of bystander CPR, survival, and quality of life following cardiac arrest. Dispatcher protocols designed to improve rapid recognition of arrest and coach CPR may increase survival by (1) reducing preventable time delays to start of chest compressions and (2) improving the quality of bystander CPR. ⋯ Simplified DA-CPR instructions to lay callers in simulated cardiac arrest settings resulted in significant reductions in time to first compression and improvements in compression depth. These results suggest an important opportunity to improve DA CPR instructions to reduce delays and improve CPR quality.
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Randomized Controlled Trial
Repetitive sessions of formative self-testing to refresh CPR skills: A randomised non-inferiority trial.
To investigate whether repetitive sessions of formative self-testing (RFST) result in an equal cardiopulmonary resuscitation (CPR) skill level compared to repetitive sessions of formative self-testing with additional practice (RFSTAP). ⋯ RFST and RFSTAP were equally effective to refresh skills within 6 weeks. After 6 months, non-inferiority was inconclusive for the combined score. Our results indicate the potential of RFST to refresh CPR skills.
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Comparative Study Observational Study
Improved outcome of extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest - A comparison with that for extracorporeal rescue for in-hospital cardiac arrest.
The aim was to investigate the effects of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) and compare the results with those of in-hospital cardiac arrest (IHCA). ⋯ In addition to having a beneficial effect in IHCA, ECPR can lead to survival and a positive neurological outcome in selected OHCA patients after prolonged resuscitation. Our results suggest that further investigation of the use of ECMO in OHCA is warranted.
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Randomized Controlled Trial
The Impact of Ultra-Brief Chest Compression-Only CPR Video Training on Responsiveness, Compression Rate, and Hands-Off Time Interval Among Bystanders in a Shopping Mall.
Recent studies have demonstrated higher-quality chest compressions (CCs) following a 60 s ultra-brief video (UBV) on compression-only CPR (CO-CPR). However, the effectiveness of UBVs as a CPR-teaching tool for lay bystanders in public venues remains unknown. ⋯ Bystanders with UBV training in a shopping mall had significantly improved responsiveness, CC rate, and decreased hands-off interval. Given the short length of training, UBV may have potential as a ubiquitous intervention for public venues to help improve bystander reaction to arrest and CO-CPR performance.