Resuscitation
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The Web-Based Registry System on In-hospital Resuscitation (WRSIR) is the first prospective, web-based, multi-site, and Utstein-based reporting system in Taiwan. This study was conducted to evaluate the feasibility of the system in one of the participating hospitals and identify prognostic factors associated with survival. ⋯ This study examined the feasibility of a web-based registry system on in-hospital resuscitation using the Utstein style in an oriental country. It provides a comprehensive and standardised method for on-line registry of data collection, allowing individual hospitals to track each case for quality improvement. A further nationwide registry will enforce the possibility of data analysis and future perspective research of in-hospital resuscitation.
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A key component of out-of-hospital emergency care is the rapid response of trained providers with appropriate medical equipment. In some communities, law enforcement agents function as first responders to accomplish this goal. The purpose of this national survey was to assess the proportion of law enforcement agencies that provide medical care to determine the extent of care they provide, to identify how many use AEDs, and to assess the attitudes of agency leaders regarding their roles as medical first responders. ⋯ Based on this survey, law enforcement agents often serve as medical first responders. Nearly three quarters of responding agencies felt this role was appropriate. AEDs are now deployed much more frequently than indicated by a previous national study, but still less than one-third of law enforcement agencies carry AEDs as part of their standard response equipment.
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Although the concept of intermittent airway occlusion with the inspiratory impedance threshold valve (ITV) is a well-recognised strategy for improving efficiency of cardiopulmonary resuscitation (CPR), little is known about possible pulmonary side effects. ⋯ In this animal model with a beating heart, intermittent airway obstruction through an ITV combined with apnoeic oxygenation and without active ventilation resulted in hypoxaemia due to transiently impaired lung function.
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A prospective manikin-based observational study of telephone-directed cardiopulmonary resuscitation.
Bystander cardiopulmonary resuscitation (CPR) significantly improves the outcome from sudden cardiac arrest (SCA) and is therefore encouraged by offering telephone instructions to the bystander. The effectiveness of this technique was examined in a manikin-based study. ⋯ Few bystanders perform CPR satisfactorily and further work is necessary to improve the effectiveness of telephone CPR instructions.
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The aim of this prospective cohort study was to describe the outcome for patients with out-of-hospital cardiac arrest in Maribor (Slovenia) over a 4 year period using a modified Utstein style, and to investigate elementary knowledge of basic life support among potential bystanders in our community. ⋯ After OHCA in a physician-based prehospital setting in our region, the overall survival to discharge was 21%. The potential bystander in our community is generally poorly educated in performing CPR, but willing to gain knowledge and skills in BLS and to follow dispatchers instructions. Arrival time, witnessed arrest, bystander CPR, initial petCO2 and final petCO2 were significantly positively related with ROSC on admission and with survival. Prehospital data from this and previous studies provide strong support for a petCO2 of 1.33 kPa to be a resuscitation threshold in the field. In our opinion the initial value of petCO2 should be included in every Utstein style analysis.