Resuscitation
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Randomized Controlled Trial
A pilot, prospective, randomized trial of video versus direct laryngoscopy for paramedic endotracheal intubation.
Prehospital intubation poses several unique challenges. Video assisted laryngoscopy has been shown to help increase intubation success in the hospital setting; however, little prospective data have examined video assisted laryngoscopy in traditional ground ambulance agencies. ⋯ In our study utilizing two ground EMS agencies, video assisted laryngoscopy with the KVL had similar first attempt success rates to direct laryngoscopy.
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Multicenter Study Comparative Study Observational Study
The Association Between Physician Turnover (the "July Effect") and Survival after In-Hospital Cardiac Arrest.
The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. ⋯ There may be a July Effect in the intensive care unit but the results were mixed. Most survival models showed a statistically significant difference but this was not supported by the secondary analyses of return of spontaneous circulation and neurological outcome. We found no July Effect in the emergency department or the medical/surgical ward for patients with in-hospital cardiac arrest.
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Multicenter Study
Initial arterial carbon dioxide tension is associated with neurological outcome after resuscitation from cardiac arrest.
To determine the relationships between partial pressure of arterial carbon dioxide (PaCO2), prescribed minute ventilation (MV), and neurologic outcome in patients resuscitated from cardiac arrest. ⋯ Initial normocarbia was associated with favorable neurological outcome in patients resuscitated from cardiac arrest. This relationship was not seen at subsequent time points. There was no significant association between prescribed MV and PaCO2or neurologic outcome.
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Randomized Controlled Trial
Integration of In-Hospital Cardiac Arrest Contextual Curriculum into a Basic Life Support Course: A Randomized, Controlled Simulation Study.
The objective was to compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). ⋯ A hospital focused BLS course utilizing RCDP was associated with improved performance on hospital-specific quality measures compared with the traditional AHA course.
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Respiratory care may be important in pediatric out-of-hospital cardiac arrest (OHCA) due to the asphyxial nature of the majority of events. However, evidence of the effect of prehospital advanced airway management (AAM) for pediatric OHCA is scarce. ⋯ In pediatric OHCA, prehospital AAM was not associated with an increased chance of neurologically favorable survival compared with BVM-only ventilation. However, careful consideration is required to interpret the findings, as there may be unmeasured residual confounders and selection bias.