Resuscitation
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Comparative Study
Therapeutic hypothermia after cardiac arrest: a retrospective comparison of surface and endovascular cooling techniques.
Therapeutic hypothermia (32-34 degrees C) is recommended for comatose survivors of cardiac arrest; however, the optimal technique for cooling is unknown. We aimed to compare therapeutic hypothermia using either surface or endovascular techniques in terms of efficacy, complications and outcome. ⋯ Endovascular cooling provides better temperature management than surface cooling, as well as a more favorable complication profile. The equivalence in outcome suggested by this small study requires confirmation in a randomized trial.
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Comparative Study
Mid-arm circumference can be used to estimate children's weights.
Accurate measurement of children's weight is rarely possible in paediatric resuscitation, and rapid estimates are made to ensure appropriate drug and fluid doses and equipment selection. Weight is commonly estimated from formulae based on children's age, or from their height using the Broselow tape. Foot-length and mid-arm circumference have also been suggested as the basis of weight-estimation formulae. ⋯ This weight-estimation formula based on mid-arm circumference is reliable for use in school-age children, and an arm-tape could be considered as an alternative to the Broselow tape in this population.
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Comparative Study
An evaluation of bag-valve-mask ventilation using an ergonomically designed facemask among novice users: a simulation-based pilot study.
We sought to compare the ability of novice operators to provide artificial ventilation using a standard facemask and a new ergonomically designed facemask. Whether or not proper technique was used was also assessed. ⋯ Novice airway operators were better able to provide facemask ventilation using an ergonomically designed mask than with a traditional facemask. We conclude that better hand position facilitating improved mask seal and less operator fatigue account for our findings.
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Neurologic prognostication after cardiac arrest relies on clinical examination findings derived before the advent of therapeutic hypothermia (TH). We measured the association between clinical examination findings at hospital arrival, 24, and 72 h after cardiac arrest in a modern intensive care unit setting. ⋯ GCS Motor score < or = 3 or < or = 2 at 24 or 72 h following cardiac arrest does not exclude survival or good outcome. However, absent pupil or corneal response at 72 h appears to exclude survival and good outcome.
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Comparative Study
Testing the validity of the ATLS classification of hypovolaemic shock.
The Advanced Trauma Life Support system classifies the severity of shock. The aim of this study is to test the validity of this classification. ⋯ In trauma patients there is an inter-relationship between derangements of HR, SBP, RR and GCS but not to the same degree as that suggested by the ATLS classification of shock.