Resuscitation
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Randomized Controlled Trial
Assessment of Advanced Life Support competence when combining different test methods--reliability and validity.
Robust assessment of Advanced Life Support (ALS) competence is paramount to the credibility of ALS-provider certification and for estimating the learning outcome and retention of ALS competence following the courses. The European Resuscitation Council (ERC) provides two sets of MCQs and four Cardiac Arrest Simulation Test (CASTest) scenarios for the assessments according to guidelines 2005. ⋯ ERC sub-tests of ALS competence possess sufficient reliability and validity. A combined ALS score with equal weighting of one MCQ and one CASTest can be used as a single measurement of ALS competence.
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Clinical Trial
Feasibility and efficacy of a new non-invasive surface cooling device in post-resuscitation intensive care medicine.
There is sufficient evidence that therapeutic hypothermia after non-traumatic cardiac arrest improves neurological outcome and reduces mortality. Many different invasive and non-invasive cooling devices are currently available. Our purpose was to show the efficacy, safety and feasibility using a non-invasive cooling device to control patient temperature within a range of 33-37 degrees C. ⋯ Using the Arctic Sun System in post-resuscitation care medicine for cooling cardiac arrest survivors is feasible and has proven to be highly effective in lowering patients' temperature rapidly without inducing skin irritations.
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The purpose of this study was to assess the long-term survival after OHCA. ⋯ Long-term survival after out-of-hospital cardiac arrest in a physician-staffed emergency system was comparable to survival after myocardial infarction with 46% being alive after ten years.
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In 2003, the International Liaison Committee on Resuscitation (ILCOR) published the "Utstein Style for Drowning" (USFD) to advance knowledge on the epidemiology, treatment, and outcome prediction after drowning. Applying the USFD and evaluating its data template for outcome analysis, we report here on the largest study published thus far of drowned children (age 0-14) who underwent attempted resuscitation on cardiopulmonary bypass (CPB). ⋯ Most variables relevant for outcome in drowned children can be documented with the use of the USFD. Additional variables not included in the USFD that have emerged from this study and may predict outcome include serum K+ concentration, rewarming speed, and initial cardiac rhythm.
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Amniotic fluid embolism (AFE) is a rare, but potentially fatal complication of pregnancy, with an incidence between 1 in 8000 and 1 in 80,000 pregnancies. The pathogenesis is not fully understood, but the generally accepted belief is that amniotic fluid enters the mother's circulation, most commonly via tears in the lower uterine segment. ⋯ AFE after blunt trauma is very rare, only described a few times in the literature. We report a case of fatal AFE after probable minor blunt trauma to the abdomen and give a review of the literature.