Resuscitation
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Despite widespread training with CPR guidelines, CPR is often poorly performed. We explore relationships between knowledge of CPR guidelines and performance (compression rate, compression depth, compression to ventilation ratio, and ventilation volume). ⋯ Although accurate knowledge of guidelines is associated with increased odds of correct performance of some aspects of CPR, overall performance remains poor.
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We sought to evaluate the knowledge of probable outcome by medical personnel for in-hospital and out-of-hospital cardiac arrests, and self-reported history of CPR training referrals for family members of cardiac patients. ⋯ This study demonstrates that medical experience is not associated with accurate estimates of cardiac arrest survival. Overwhelmingly, medical personnel believe family members should be trained to perform CPR, however, few refer family members for CPR training.
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Blood flow during conventional cardiopulmonary resuscitation (CPR) is usually less than adequate to sustain vital organ perfusion. A new chest compression device (LifeBelt) which compresses both the sternum and the lateral thoraces (compression and thoracic constraint) has been developed. The device is light weight, portable, manually powered and mechanically advantaged to minimize user fatigue. The purpose of this study was to evaluate the mechanism of blood flow with the device, determine the optimal compression force and compare the device to standard manual CPR in a swine arrest model. ⋯ Blood flow with the LifeBelt device is primarily the result of cardiac compression. At a sternal force of 100-130 lb (45-59 kg), the device produces greater CPP than well-performed manual CPR during resuscitation from prolonged VF.
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In this report we discuss a patient with predominant right heart failure and pulmonary hypertension, caused by thyrotoxicosis due to Graves disease, which deteriorated to asystole, due to amiodarone administration for rapid atrial fibrillation.
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Guideline-directed therapy during the first minutes of resuscitation may be life saving. This study assessed the performance of American Heart Association (AHA) guidelines by trained departmental staff in the period between discovery of collapse and emergency team arrival. ⋯ Trained departmental staff performed poorly in the moments between patient discovery and arrival of the emergency team. Since patient outcomes were comparable to those described in the literature, poor resuscitation performance may be commonplace in hospitals where ward personnel are expected to deliver advanced life support prior to arrival of the emergency team.