Resuscitation
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High quality cardiopulmonary resuscitation (CPR) in the pre-hospital setting has been associated with improved survival rates during cardiopulmonary arrest (CPA). Recent documentation of hyperventilation associated deterioration in hemodynamics during CPR, suggests that guided or controlled ventilation strategies may contribute to improved hemodynamics and increased survival. ⋯ The use of improved thoracic impedance pneumography and capnography are appealing for such monitoring because of the widespread availability, but modifications to existing software and clinical data compared to a clinical standard would be required before general acceptance is possible. Other methods listed may offer advantages over these in select circumstances.
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Randomized Controlled Trial Comparative Study
Airway management by paramedics using endotracheal intubation with a laryngoscope versus the oesophageal tracheal Combitube and EasyTube on manikins: a randomised experimental trial.
The EasyTube, which is constructed in a similar way to the Combitube, is a recently introduced alternative to tracheal intubation for airway management in emergency medicine. ⋯ For paramedics tested on manikins placement success rate was higher with less time required for the Combitube and Easytube than for tracheal intubation with no differences between the Combitube and EasyTube.
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Comparative Study
In-hospital cardiac arrest: is outcome related to the time of arrest?
Whether outcome from in-hospital cardiopulmonary resuscitation (CPR) is poorer when it occurs during the night remains controversial. This study examined the relationship between CPR during the various hospital shifts and survival to discharge. ⋯ Although unwitnessed arrest is more prevalent during night shift, resuscitation during this shift is associated with poorer outcomes independently of witnessed status. Further research is required into the causes for the increased mortality observed after night shift resuscitation.
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Randomized Controlled Trial Comparative Study
One-handed versus two-handed chest compressions in paediatric cardio-pulmonary resuscitation.
To determine emergency department (ED) staff preference for one- or two-handed paediatric chest compressions and to determine if there was a difference in compression rates delivered and fatigability between the techniques. ⋯ This study showed that CPR compression rate is similar with one- and two-handed compression techniques, but compression rate decreased more quickly with the one-handed technique. The majority of staff preferred the two-handed compression technique for reasons of ease, control and uniformity with other CPR techniques.