Resuscitation
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Observational Study
Cardiopulmonary resuscitation duty cycle in out-of-hospital cardiac arrest.
Duty cycle is the portion of time spent in compression relative to total time of the compression-decompression cycle. Guidelines recommend a 50% duty cycle based largely on animal investigation. We undertook a descriptive evaluation of duty cycle in human resuscitation, and whether duty cycle correlates with other CPR measures. ⋯ Duty cycle was below the 50% recommended guideline, and was associated with compression depth and rate. These findings provider rationale to incorporate duty cycle into research aimed at understanding optimal CPR metrics.
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The percentage of unrecognised orotracheal tube displacement in an out-of-hospital setting has been reported to be between 4.8% and 25%. The aim of our study was to assess the sensitivity and specificity of Point-of-Care-UltraSound (POCUS) for confirming the proper tube position after an urgent orotracheal intubation in an out-of-hospital setting and the time needed for POCUS. ⋯ Results of our study support POCUS as an accurate and reliable method for confirming the proper orotracheal tube placement in trachea and it is feasible for out-of-hospital setting implementation. POCUS also seems to be time saving method but to make definitive conclusion more studies should be done.
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To compare outcome in patients with acute myocardial infarction (MI) and cardiogenic shock (CS) presenting with and without out-of-hospital cardiac arrest (OHCA). ⋯ OHCA is not an independent predictor of mortality in patients with acute MI complicated by cardiogenic shock. This should encourage active intensive treatment of CS patients regardless of OHCA.
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Randomized Controlled Trial Multicenter Study
Minimizing Pre-shock Chest Compression Pauses in a Cardiopulmonary Resuscitation Cycle by Performing an Earlier Rhythm Analysis.
Guidelines recommend 2min of CPR after defibrillation attempts followed by ECG analysis during chest compression pause. This pause may reduce the likelihood of return of spontaneous circulation (ROSC) and survival. We have evaluated the possibility of analysing the rhythm earlier in the CPR cycle in an attempt to replace immediate pre-shock rhythm analysis. ⋯ While a shockable rhythm 1min post-shock was present also immediately before next possible defibrillation attempt in most cases, three patients had ROSC. Studies are needed to document if moving the pre-shock rhythm analysis will increase shocks delivered to organized rhythms, and if it will increase shock success and survival.
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Randomized Controlled Trial
Performance of chest compressions with the use of a new audio-visual feedback device: A randomized manikin study in health care professionals.
Optimal depth (50-60mm) and rate (100-120min(-1)) of chest compressions (CC) is the prerequisite of effective cardiopulmonary resuscitation (CPR). However, insufficient CC during CPR are common even among health care professionals. We sought to evaluate if CC are more effective with the use of a novel feedback device compared to standard CC. Primary endpoints were absolute percentage of correct CC of all CC (correct rate and correct depth, classified as "optimal" CC), and the percentage of CC in target rate and percentage of CC in target depth. ⋯ This novel feedback device significantly improved the quality of CC in health care professionals.