Resuscitation
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This is the first study to look at the effects of cricoid pressure/laryngeal manipulation on the laryngeal view and intubation success in the emergency or pre-hospital environment. Cricoid pressure is applied in the hope of reducing the incidence of aspiration. However the technique has never been evaluated in a randomized trial and may adversely affect laryngeal view. In order to improve intubating conditions cricoid pressure may be released and the larynx manipulated into a more favourable position. ⋯ The results suggest that cricoid pressure should be removed if the laryngeal view obtained is not sufficient to allow immediate intubation. Further manipulation of the larynx is likely to improve the chances of successful tracheal tube placement.
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This study aims to determine the failure rate of transplanted kidney grafts in recipients of organs from non-heart beating donors (NHBDs) who have had mechanical chest compressions to maintain a circulation before organ retrieval. ⋯ We have described our experience and protocol for non-heart beating donation using victims of out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation has been unsuccessful as donors. Primary kidney graft failure rates in organs from non-heart beating donors is similar when manual or mechanical chest compression devices are used during cardiopulmonary resuscitation.
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Determine the effect of residual leaning force on intrathoracic pressure (ITP) in healthy children receiving mechanical ventilation. We hypothesized that application of significant residual leaning force (2.5kg or 20% of subject body weight) would be associated with a clinically important change in ITP. ⋯ In healthy anesthetized children, changes in ETP were detectable at residual leaning forces as low as 10% of subject body weight. Residual leaning force of 2.5kg was associated with increases in ETP >or=2.0cmH(2)O.
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Editorial Comment Comparative Study
Propensity, prophecy, and perplexity: does in-hospital extracorporeal cardiopulmonary resuscitation really make a difference?
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Transport of patients with ongoing cardiopulmonary resuscitation (CPR) occurs frequently. It may not be possible to obtain rapid hospital access while maintaining CPR quality, because the ambulance's high speed can cause increased vibration and vehicle movement. We aimed to assess how the speed of ambulance affects chest compressions. ⋯ The speed of ambulance affects some aspects in the quality of chest compression during transport. Chest compressions with excessive depth, the average rate of chest compressions, and no-flow fraction increase as the speed of ambulance increase. Increase in the speed of ambulance also causes relative increase of high frequency acceleration in the chest compression, which represents unnecessary movement and force applied.