Resuscitation
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Skill decay is a recognised problem in resuscitation training. Spaced learning has been proposed as an intervention to optimise resuscitation skill performance compared to traditional massed learning. A systematic review was performed to answer 'In learners taking resuscitation courses, does spaced learning compared to massed learning improve educational outcomes and clinical outcomes?' ⋯ Despite the very low certainty of evidence this systematic review suggests that spaced learning can improve skill performance at 1 year post course conclusion and skill performance between course conclusion and 1 year. There is a lack of data from this educational intervention on skill performance in clinical resuscitation and patient survival at discharge with favourable neurological outcomes.
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Review
Acute clinical deterioration and consumer escalation in the hospital setting: A literature review.
Consumer escalation systems that allow patients and/or their family/carers to escalate concerns about clinical deterioration have been proposed as a way of enhancing patient safety. However, evidence to guide implementation or to support system effectiveness remains unclear. ⋯ The ability of consumer escalation processes to achieve their underlying goals is still to be adequately assessed. Further research is required to inform how to best implement, support and optimise consumer escalation systems.
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Ventilation rate is a confounding factor for interpretation of end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR). The aim of our study was to model the effect of ventilation rate on ETCO2 during manual CPR in adult out-of-hospital cardiac arrest (OHCA). ⋯ Capnogram interpretation during CPR is challenging since many factors influence ETCO2. For adequate interpretation, we need to know the effect of each factor on ETCO2. Our model allows quantifying the effect of ventilation rate on ETCO2 variation. Our findings could contribute to better interpretation of ETCO2 during CPR.
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Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is a critical first step along the resuscitation pathway. Barriers to recognition may lead to adverse outcomes among patients. This study aims to determine the impact of seizure-like activity among OHCA patients during 9-1-1 calls. ⋯ Reported seizure-like activity among patients in cardiac arrest poses a barrier to recognition of cardiac arrests by dispatchers leading to delays in resuscitation instructions.
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Observational Study
Prospective evaluation of airway management in pediatric out-of-hospital cardiac arrest.
The objective of the study was to identify the association between airway management modality and time to the initial dose of epinephrine in pediatric out-of-hospital cardiac arrest (OHCA). ⋯ In this prospective study, the airway management modality was not associated with the time to the initial dose of epinephrine. Unexpectedly, pneumonia was significantly more common among children treated with TI compared to BMV. SGAs had high first-attempt success rates, while intubation success rates were low.