Resuscitation
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Letter Observational Study
Use of mechanical cardiocompressor in uncontrolled donation after cardiac death.
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While therapeutic hypothermia (TH) is an effective neuroprotective therapy for neonatal hypoxic-ischemic encephalopathy, TH has not been demonstrated to improve outcome in other pediatric populations. Patients with acquired or congenital heart disease (CHD) are at high risk of both cardiac arrest and neurodevelopmental impairments, and therapies are needed to improve neurologic outcome. The primary goal of our study was to compare safety/efficacy outcomes in post-arrest CHD patients treated with TH versus controls not treated with TH. ⋯ Our data show that pediatric CHD patients who suffer cardiac arrest can be treated effectively and safely with TH, which may decrease the incidence of seizures.
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The aim of this study was to investigate regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest (OHCA) in Australia and New Zealand. ⋯ In the first results of the Aus-ROC Australian and New Zealand OHCA Epistry, significant regional variation in the incidence, characteristics and outcomes was observed. Understanding the system-level and public health drivers of this variation will assist in optimisation of the chain of survival provided to OHCA patients with the aim of improving outcomes.
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Observational Study
Ten years of cardiac arrest resuscitation in Irish general practice.
The aim of this study is to establish the role and outcome of general practitioner (GP) involvement in out of hospital cardiac arrest (OHCA) resuscitation in the Republic of Ireland. ⋯ Resuscitation following OHCA is a key task in general practice. Over time a significant number of GPs encounter OHCA, attempt resuscitation and achieve higher survival to hospital discharge rates than occur nationally among OHCAs in Ireland. We conclude that a defibrillator should be routinely available at all general practices and staff should have appropriate resuscitation skills.
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The chain of survival aims to demonstrate the interrelationship between key stages of resuscitation and emphasises the need for all links to be effective in order to optimise the chances of survival. The contribution of each of the four links diminishes rapidly as patients succumb at each stage and the actual attrition rate results in rapidly decreasing numbers of patients progressing along the chain. This revised representation adjusts the area of each link in order to graphically represent the flow of patients through the chain. Greatest benefit in improving outcome will be achieved by focussing on improving care at links in the chain where there is the greatest number of patients.