Resuscitation
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Every member of a healthcare organisation should be able to perform cardiopulmonary resuscitation and defibrillation (CPR-D). The purpose of this cohort study was to examine medical and nursing student's beliefs and attitudes toward CPR-D and current practice guidelines. ⋯ Medical students' attitudes mature as hoped for, but the nursing students need encouragement. More information is needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the students' attitudes toward practice guidelines.
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Construction of an effective in-hospital resuscitation programme is challenging. To document and analyse resuscitation skills assessment must provide reliable data. Benchmarking with a hospital having documented excellent results of in-hospital resuscitation is beneficial. The purpose of this study was to assess the resuscitation skills to facilitate construction of an educational programme. ⋯ Assessment of CPR-D skills gave valuable information for further education in both hospitals. Defining and teaching leadership seems to improve resuscitation performance.
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The purpose of this study was to determine the clinical value of arterial minus end-tidal CO(2) [P(a-et)CO(2)] and alveolar dead space ventilation ratio (V(dA)/V(t)) as indicators of hospital mortality in patients that have been resuscitated from cardiac arrest at emergency department. ⋯ This study showed that high serum lactate, high P(a-et)CO(2) and high V(dA)/V(t) during early ROSC in cardiac arrest patients suggest high hospital mortality. If future studies validate this model, the P(a-et)CO(2) and V(dA)/V(t) may provide useful guidelines for the early post-resuscitation care of cardiac arrest patients in emergency departments.
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In this study we aimed to report survival beyond 6 months, including quality of life, for patients after out-of-hospital cardiac arrest (OHCA) with a physician-based EMS in an urban area. ⋯ Survival beyond 6 months was found in 12.3% OHCA in a physician-based EMS. Summary scores of quality of life were not significantly different from the national norm but 2 out of 8 subscores were lower. Signs of dementia were uncommon as only 6% had an MMSE score below 24.
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Adrenergic immuno-modulation mediated by beta-adrenergic receptors has been demonstrated. Pharmacological blockade of beta-adrenergic receptors is a therapeutic intervention frequently used in critically ill patients. The effect of beta-adrenergic blockade on cellular immune functions in a critical illness, such as polymicrobial sepsis, has not been investigated. ⋯ beta-Adrenergic blockade was accompanied by alterations of cellular immune functions, a deterioration in the clinical situation and a reduced survival in a murine model of sepsis. These data demonstrate the potential immuno-modulatory effects of beta-adrenergic antagonists.