Resuscitation
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The purpose of this study was to investigate whether the takeover by Advanced Life Support [ALS] trained ambulance paramedics from rescuers using an automated external defibrillator [AED] delays shocks and if this delay is associated with decreased survival after out-of-hospital cardiac arrest [OHCA]. ⋯ ALS takeover delays the next shock delivery in almost two-third of cases. This delay is associated with decreased survival.
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To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning. ⋯ Predictive pre-resuscitation factors may supplement patient-specific information available at bedside to assist in revising resuscitation plans during the patient's hospitalization.
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Comparative Study
Increase in pre-shock pause caused by drug administration before defibrillation: an observational, full-scale simulation study.
The importance of circulation during cardiopulmonary resuscitation has led to efforts to decrease time without chest compressions ("no-flow time"). The no-flow time from the interruption of chest compressions until defibrillation is referred to as the "pre-shock pause". A shorter pre-shock pause increases the chance of successful defibrillation. It is unclear whether drug administration affects the length of the pre-shock pause. Our study compares pre-shock pause with and without drug administration in a full-scale simulation. ⋯ Drug administration prior to defibrillation was associated with significant increases in pre-shock pauses in this full-scale simulation study.
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Biography Historical Article
Dominique-Jean Larrey: the effects of therapeutic hypothermia and the first ambulance.
The fields of emergency medicine and resuscitation are indebted to the Baron Dominique-Jean Larrey (1766-1842) for significant advances in patient care. Larrey was a great surgeon who served in the French army during Napoleon's rule. ⋯ Larrey coined the term "Triage" to allocate resources to those most in need of emergent care. Today, many of his techniques still prevail in modern medicine.
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Total liquid ventilation (TLV) with cooled perfluorocarbons has been demonstrated to induce an ultrafast cardioprotective cooling in rabbits. However, it remains unknown whether this technically challenging strategy would be actually more potent than a conventional external cooling after a prolonged ischemia inducing transmural myocardial infarction. ⋯ Cooling induced by TLV afforded a potent cardioprotection and prevented transmural infarction following prolonged and severe ischemia, even when started later than a surface cooling in rabbits.