Resuscitation
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Comparative Study
Does an advanced life support course give non-anaesthetists adequate skills to manage an airway?
Traditionally, anaesthetists have provided airway management skills on resuscitation teams. Because advanced life support (ALS) courses teach practical airway management, some UK hospitals have dropped anaesthetists from cardiac arrest teams. Does the ALS course give non-anaesthetists adequate skills to manage an airway during a cardiac arrest? ⋯ The airway component of an ALS course alone does not give adequate practical skills for non-anaesthetists to manage an airway in an anaesthetised patient. Airway management at a cardiac arrest is unlikely to be any better.
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Comparative Study
A randomized comparison of cardiocerebral and cardiopulmonary resuscitation using a swine model of prolonged ventricular fibrillation.
Cardiocerebral resuscitation (CCR) is reportedly superior to cardiopulmonary resuscitation (CPR) for primary cardiac arrest in the prehospital setting. This study was done using a swine model of prolonged ventricular fibrillation (VF) to quantify the effect of the emergency medical services component of CCR with intraosseous access (CCR-IO) compared with standard CPR with intravenous access (CPR-IV) as it is typically performed during out-of-hospital cardiac arrest (OHCA) resuscitation in a prospective randomized fashion. ⋯ In this swine model of witnessed VF arrest with no bystander-initiated resuscitation, CCR-IO resulted in substantial improvement in all three outcomes relative to typical emergency medical services provided CPR-IV.
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Two simple questions have been used to classify neurologic outcome in patients with stroke. Could they be similarly applied to patients with cardiac arrest? ⋯ Neurologic outcomes based on the two simple questions after cardiac arrest can be easily determined, sensibly applied, and readily interpreted. These preliminary findings justify further evaluation of this simple and practical approach to classify neurologic outcome in survivors of cardiac arrest.
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We examined the relationship between time from collapse to arrival of emergency medical services (EMS) and survival to hospital discharge for out-of-hospital ventricular fibrillation cardiac arrests in order to determine meaningful interpretations of this association. ⋯ The results of our analyses show that survival from out-of-hospital cardiac arrest does not decline at a constant rate following collapse. Models that incorporate changes that reflect the physiological alterations that occur following cardiac arrests are a more accurate way to describe changes in survival rates over time than models that include only a continuous term for time.
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There is no study regarding the influence of cardiopulmonary resuscitation (CPR) guideline renewal on citizen's attitude towards all basic life support (BLS) actions. ⋯ Future guidelines should emphasise the significance and benefit of early call in relation to telephone-assisted instruction of CPR or chest compression. The course instructors should be aware of the backgrounds of participants as to how this may relate to their willingness to participate.