Resuscitation
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Patients who survive after suicidal hanging attempts suffer from transient brain ischaemia. Morbidity and mortality is high, and no specific therapy is available. Hypothermia attenuates ischaemic brain damage and has become standard care in comatose survivors of cardiac arrest; therapeutic hypothermia may thus be useful for near-hanging victims as well. ⋯ No randomised, controlled trial for treatment of near-hanging victims has been published. No conclusions could be drawn regarding treatment effects of hypothermia in this survey, but in the absence of better evidence, it seems reasonable to consider hypothermia treatment in all comatose near-hanging victims.
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Randomized Controlled Trial
The significance of clinical experience on learning outcome from resuscitation training-a randomised controlled study.
The impact of clinical experience on learning outcome from a resuscitation course has not been systematically investigated. ⋯ Half a year of clinical experience, before participation in an ALS course had a small but statistically significant impact on the retention of learning, but not on the immediate learning outcome.
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Randomized Controlled Trial
Defibrillation and the quality of layperson cardiopulmonary resuscitation-dispatcher assistance or training?
To examine whether basic life support-defibrillation (BLS-D) training of laypersons enhances the speed of defibrillation and the quality of cardiopulmonary resuscitation (CPR) during a simulated ventricular fibrillation scenario compared with a situation where the care provider has no previous BLS-D training but receives dispatcher assistance with the use of an automated external defibrillator (AED) and the performance of CPR. ⋯ Training improved the quality of mouth-to-mouth ventilation performed by laypersons but had only a minor effect on defibrillation and the quality of compressions.
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Controlled Clinical Trial
The cutoff values of intrathecal interleukin 8 and 6 for predicting the neurological outcome in cardiac arrest victims.
To evaluate the changes in inflammatory cytokines, such as interleukin (IL)-8 and IL-6, in the cerebrospinal fluid (CSF) and serum, and to identify any correlations with the neurological outcomes in patients resuscitated from cardiopulmonary arrest (CPA). ⋯ We demonstrated the cutoff values of IL-8 and IL-6 in the CSF to predict the neurological outcome in the patients resuscitated from CPA. The excessive inflammatory cytokine reactions in the brain might therefore be related to the poor neurological outcome in patients with post-resuscitation encephalopathy.
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Survival rate after out-of-hospital cardiac arrest (OHCA) has not significantly increased over the last decade. However, survival rate has been used as a quality benchmark for many emergency medical services. A uniform resuscitation registry may be advantageous for quality management of cardiopulmonary resuscitation (CPR). This study was conducted to evaluate the establishment of a national CPR registry in Germany. ⋯ The data set 'Preclinical care' proved to be congruent with the Utstein style, provided further information for national and international comparisons, and enabled a detailed analysis. Optimisation of data collection and introduction of strict control mechanisms may further improve data quality.