Resuscitation
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Review Meta Analysis
The Use of High-Fidelity Manikins for Advanced Life Support Training-A Systematic Review and Meta-analysis.
The objective of this study was to evaluate the effectiveness of high versus low fidelity manikins in the context of advanced life support training for improving knowledge, skill performance at course conclusion, skill performance between course conclusion and one year, skill performance at one year, skill performance in actual resuscitations, and patient outcomes. ⋯ The use of high fidelity manikins for advanced life support training is associated with moderate benefits for improving skills performance at course conclusion. Future research should define the optimal means of tailoring fidelity to enhance short and long term educational goals and clinical outcomes.
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Review Meta Analysis
Endotracheal Intubation versus Supraglottic Airway Placement in Out-of-Hospital Cardiac Arrest: A Meta-Analysis.
Overall survival from out-of-hospital cardiac arrest (OHCA) is less than 10%. After initial bag-valve mask ventilation, 80% of patients receive an advanced airway, either by endotracheal intubation (ETI) or placement of a supraglottic airway (SGA). The objective of this meta-analysis was to compare patient outcomes for these two advanced airway methods in OHCA patients treated by Emergency Medical Services (EMS). ⋯ Patients with OHCA who receive ETI by EMS are more likely to obtain ROSC, survive to hospital admission, and survive neurologically intact when compared to SGA.
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Airway management, mechanical ventilation and resuscitation can be performed almost everywhere--even in space--but not under water. The present study assessed the technical feasibility of resuscitation under water in a manikin model. ⋯ Airway management under water appears to be feasible in this manikin model. The suction system requires further modification. Mechanical ventilation at depth is possible but modifications of the Oxylator(®) are required to stabilize ventilation rate and administered minute volumes. The LUCAS™ 1 cannot be recommended at major depth.
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Randomized Controlled Trial
Post-Discharge Outcomes After Resuscitation from Out-of-Hospital Cardiac Arrest: A ROC PRIMED SUBSTUDY.
Assessment of morbidity is an important component of evaluating interventions for patients with out-of-hospital cardiac arrest (OHCA). ⋯ The majority of patients in this large cohort who survived cardiac arrest and were interviewed had no, mild or moderate health impairment. Concern about poor quality of life is not a valid reason to abandon efforts to improve an EMS system's response to cardiac arrest.