Resuscitation
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Randomized Controlled Trial
Evaluation of M-AID, a first aid application for mobile phones.
When performed effectively, cardiopulmonary resuscitation (CPR) by bystanders reduces mortality due to sudden cardiac arrest. Telemedicine applications offer a means by which bystanders can get specific instructions for handling the emergency situation. M-AID, a first aid application for mobile phones, uses an intelligent algorithm of 'yes' or 'no' questions to judge the ongoing situation and give the user detailed instructions. The aim of this study was to evaluate the benefit of this mobile phone application in a scenario of sudden cardiac arrest. ⋯ Experience in the use of mobile phones is a prerequisite for the efficient use of the tested M-AID version. This application cannot replace skills acquisition by practical training. In a subgroup with experience in mobile phone use and basic knowledge in CPR, the device improved performance of CPR.
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The quality of cardiopulmonary resuscitation (CPR) plays a crucial role in saving lives from out-of-hospital cardiac arrest (OHCA). Previous studies have identified sub-optimal CPR quality in the prehospital settings, but the causes leading to such deficiencies were not fully elucidated. ⋯ Many unnecessary no-chest compression intervals were identified during ambulance CPR, and most of this was operator, rather than ambulance related. Though a mechanical device could minimise the no-chest compression intervals after activation, it took considerable time to deploy in a system with short transport time. Human factors remained the most important cause of poor CPR quality. Ways to improve the CPR quality in the ambulance warrant further study.
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Multicenter Study
The effect of a critical care outreach service and an early warning scoring system on respiratory rate recording on the general wards.
To determine whether the implementation of a Reading-Modified Early Warning Scoring (R-MEWS) system, is associated with an increased recording of respiratory rate (RR) in hospital inpatients, and whether the presence of a critical care outreach (CCO) service has a further impact on the recording of patient's vital signs. ⋯ The introduction of an early warning scoring (EWS) was associated with improved respiratory rate recording, which may have been further enhanced by the presence of a CCO service.
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Studies have suggested that emesis may occur in up to a third of cardiac arrest patients. The goal of this investigation was to characterize the frequency, timing, and outcome association of emesis in persons suffering out-of-hospital cardiac arrest in order to understand the role and care-implications of emesis better. ⋯ Given the frequency of emesis, the potential that some portion of emesis may be related to care, and the adverse association between emesis and survival, approaches that treat or prevent emesis better may improve the chances of survival following out-of-hospital cardiac arrest.
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To investigate whether transoesophageal cardiac pacing can induce ventricular fibrillation (VF) and how long the cardiac pacing has to be sustained to prevent the reversion of the VF induced. ⋯ Transoesophageal cardiac pacing can induce VF in rats. However, the cardiac pacing is required for at least 120-180 s to ensure that VF does not spontaneously convert. We can use the technique to establish a new and simpler rat cardiac arrest (CA) model, which may facilitate experimental investigation on CPR.