Resuscitation
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Fifty years ago, the ad hoc committee of the Harvard medical school provided the influential first guidance on confirming death using neurological criteria (DNC). Now 70% of countries have a legal or professional framework enabling DNC. ⋯ The legacy of the Harvard ad hoc committee has been a continuing development of our concepts of human death. There is a growing acceptance that ultimately all human death is brain based whether diagnosed using neurological criteria or using circulatory criteria after cardiac arrest.
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Laryngeal tubes (LT) are supraglottic airway devices routinely used in emergency airway management. During cardiac arrest in a swine model, the carotid artery blood flow is reduced after insertion of a LT. A compression of the internal carotid (ICA) artery by the inflated cuff was shown. Up to now there is no information if the LT has similar effects in humans with possible negative implications for use of the LT in case of cardiac arrest. ⋯ In humans the LT does not impair blood flow of the internal carotid artery during ventilation in general anaesthesia. Further studies are needed to confirm our findings under the conditions of cardiac arrest.
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Randomized Controlled Trial Multicenter Study
The Use of Dispatcher Assistance in Improving the Quality of Cardiopulmonary Resuscitation: A Randomised Controlled Trial.
The introduction of dispatcher assistance (DA) services has led to increased bystander cardiopulmonary resuscitation (CPR) participation rates. However, the extent to which DA improves CPR quality remains unclear. This study aimed to evaluate the efficacy of DA in improving CPR quality among healthcare professionals and laypersons within a multi-ethnic Southeast Asian population. ⋯ DA should be provided to laypersons without valid CPR certification, as well as healthcare professionals. The identification of gaps in the current DA protocol highlights areas where specific changes can be made to improve CPR quality.
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Review Meta Analysis
Advanced airway interventions for paediatric cardiac arrest: A systematic review and meta-analysis.
To assess the use of advanced airway interventions (tracheal intubation (TI) or supraglottic airway (SGA) placement), compared with bag mask ventilation (BMV) alone, for resuscitation of children in cardiac arrest. ⋯ TI or SGA are not superior to BMV for resuscitation of children in cardiac arrest, but the overall certainty of evidence is low to very low. Well designed randomised efficacy trials are needed to address this important question.