Resuscitation
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Recent accidents with helicopter emergency medical service (HEMS) aircraft raise the question how safe HEMS in Germany is and how accidents could be prevented. ⋯ HEMS-safety could be improved by special training programmes for pilots and HEMS-crewmembers to address the factors listed above. Safety training for doctors is recommended but we did not find support for the notion of changing the doctor's legal position of a passenger to a HEMS-crewmember.
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Case Reports
Reconfirmation algorithms should be the standard of care in automated external defibrillators.
Non-sustained and self-terminating arrhythmias pose a significant challenge during resuscitation. Delivery of a defibrillation shock to a non-shockable rhythm has a poorly understood effect on the heart. ⋯ A case of spontaneous reversion of a non-sustained arrhythmia is presented. The implications of delivering a defibrillator shock to a non-shockable rhythm are discussed.
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In-hospital cardiac arrest is one of the most stressful situations in modern medicine. Since 1997, there has been a uniform way of reporting - the Utstein guidelines for in-hospital cardiac arrest reporting. ⋯ The current study is the largest single-centre study of in hospital cardiac arrest reported according to the Utstein guidelines. We report a high survival for in-hospital cardiac arrest. We have pointed out that a functional chain of survival, short intervals before the start of CPR and defibrillation are probably contributing factors for this.
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Randomized Controlled Trial
Quality of BLS decreases with increasing resuscitation complexity.
Multiple procedures performed in parallel may cause each procedure to be performed less effectively than if performed in isolation. BLS performed by prehospital providers potentially includes artificial ventilations, chest compressions, and application of an automated external defibrillator (AED). This study examines the effectiveness of artificial ventilation and chest compressions both with and without an AED. ⋯ Both the quality and quantity of BLS decreases as the number of procedures performed simultaneously increases. Further decrements might occur when ALS skills enter into resuscitation. These results suggest a need to automate and/or prompt the performance of BLS to optimize resuscitation.