Resuscitation
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Randomized Controlled Trial
Effect of cooling after human cardiac arrest on myocardial infarct size.
The Hypothermia after Cardiac Arrest (HACA) trial assessed whether mild therapeutic hypothermia improved the rate of good neurological recovery in patients after ventricular fibrillation cardiac arrest of presumed cardiac origin. We evaluated the impact of hypothermia on myocardial injury. ⋯ Cooling after successful resuscitation for ventricular fibrillation cardiac arrest did not influence infarct size. Cautious interpretation of the subgroup analysis may indicate a favourable trend for early cooling.
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Taiwan is a small island country located in East Asia. From around 1995 modern concepts of the EMS were imported and supported by legislation. Considerable progress has since been made towards the construction of an effective pre-hospital care system. ⋯ The features and problems of in-hospital emergency care are also discussed. Key areas for further development in the country vary depending on regional differences in available resource and population density. An analysis of the strength, weakness, opportunity, and threats of the evolving EMS in Taiwan could be an example for other countries where the EMS is undergoing a similar process of development and optimisation.
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Approximately 750,000 in-hospital cardiac arrests occur annually in the United States. Many will occur to visitors or staff members within the hospital's public areas. We sought to provide a descriptive analysis of visitor cardiac arrests in hospitals and to compare survival outcomes to matching inpatient arrests. ⋯ Cardiac arrest among hospital visitors is a relatively common event. The survival outcomes of hospital visitors compared unfavorably to that of recently published experience with out-of-hospital cardiac arrest victims.
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Randomized Controlled Trial
Reduced hands-off-time and time to first shock in CPR according to the ERC Guidelines 2005.
Chest compressions and early defibrillation are crucial in cardiopulmonary resuscitation (CPR). The Guidelines 2005 brought major changes to the basic life support and automated external defibrillator (BLS-AED) algorithm. We compared the European Resuscitation Council's Guidelines 2000 (group '00) and 2005 (group '05) on hands-off-time (HOT) and time to first shock (TTFS) in an experimental model. ⋯ In this manikin setting, HOT and TTFS improved with BLS-AED performed according to Guidelines 2005.
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We sought to evaluate the association between three key out-of-hospital endotracheal intubation (ETI) errors and patient outcomes. ⋯ Out-of-hospital ETI errors are not associated with mortality. Failed out-of-hospital ETI increases the odds of pneumonitis.