Resuscitation
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To review the characteristics and outcome of cardiopulmonary resuscitation in children at a rural hospital in Kenya. ⋯ Cardiopulmonary arrest after admission has a very poor prognosis in our hospital. Infectious diseases are the main underlying causes of arrest. If a child fails to respond to the basic tenements of PALS within 15 min then it is unlikely that further efforts to sustain life will be fruitful in hospitals where ventilation facilities are not present.
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To assess the long-term outcome of bystander-witnessed out-of-hospital cardiac arrest victims in Estonia by using the survival rate and quality of life assay. ⋯ In Estonia majority of bystander-witnessed out-of-hospital cardiac arrest victims who survive hospital discharge are alive one and also more than three years after resuscitation. Their quality of life is worse than that of general population.
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Hypothermia has been shown to improve survival and neurological outcomes for ventricular fibrillation (VF) cardiac arrest. The electrophysiological mechanisms of hypothermia are not well-understood, nor are the effects of beginning cooling during the resuscitation. ⋯ Hypothermia slowed the decay of the ECG waveform during prolonged VF. IRH improved ROSC but not short-term survival compared to NORM. It is possible to rapidly induce mild hypothermia during CPR using an IV infusion of ice-cold saline.
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To determine the reliability of pulse palpation to diagnose paediatric cardiac arrest. ⋯ Pulse palpation is unreliable to diagnose paediatric cardiac arrest. Rescuers misdiagnose on 22% of occasions and which may lead them to withhold external cardiac compression on 14% of occasions when needed and on 36% to give it when not needed. Brachial palpation is slightly more reliable than femoral palpation.
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We report the successful use of the Proseal laryngeal mask airway as a rescue device in three pre-hospital cases where tracheal intubation after induction of anaesthesia had failed. The ProSeal LMA allowed ventilation and oxygenation of all three patients under difficult circumstances.