Resuscitation
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The aim of this study is to analyse the causes of cardiac arrests (CA) in the emergency departments (ED) in the United States and their clinical outcomes according to whether they had a primary or a secondary diagnosis of CA. ⋯ Survival with CA in ED is <30% of patients and is greater among patients with a secondary diagnosis of CA. CAs are associated with significant mortality in ED and hospital settings and measures should be taken to better manage cardiac, infection and respiratory causes particularly in the winter months.
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Observational Study
Testing the Effects of Checklists on Team Behaviour During Emergencies on General Wards: An Observational Study using High-Fidelity Simulation.
Clinical teams struggle on general wards with acute management of deteriorating patients. We hypothesized that the Crisis Checklist App, a mobile application containing checklists tailored to crisis-management, can improve teamwork and acute care management. ⋯ Implementation of a novel mobile crisis checklist application among clinical teams was associated in a simulated general ward setting with improved teamwork performance, and a higher and faster completion rate of predetermined safety-critical steps.
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A robust estimation method is needed to prevent medication dosing and equipment sizing errors and improve time to administration during paediatric resuscitation. An electronic measurement with computer interface may improve accuracy and alleviate cognitive burden. This study evaluates the accuracy of two electronic height measurement methods, a laser and an optical device, and compares them to the Broselow™ Pediatric Emergency Tape (BT) for weight estimation. ⋯ Electronic-based weight estimates were more accurate than the BT. The accuracy of medication dosing and equipment sizing during paediatric resuscitation may be improved by integrating optical height-based weight estimates with electronic clinical decision support.
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The immediate delivery room (DR) management of non-vigorous (NV) infants with meconium stained amniotic fluid (MSAF) is controversial. A recent ILCOR suggestion is not to perform routine direct laryngoscopy (DL) with or without tracheal suctioning in NV infants. Our practice is to perform DL and endotracheal (ET) suctioning in targeted NV infants. The study objective was to describe the perinatal characteristics and DR Management of infants born through MSAF and admitted to the neonatal intensive care unit (NICU).
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Randomized Controlled Trial
Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest.
Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated whether MRI/S by randomized group. ⋯ Regional cerebral and metabolic MRI/S biomarkers are predictive of neurological outcomes at hospital discharge in pediatric cardiac arrest and should undergo validation testing in a large sample.