Resuscitation
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We report on the case of a patient who suffered a cardiac arrest in ventricular fibrillation (VF), leading to a decerebrate state, who made a rapid complete neuronal recovery following the institution of continuous renal replacement therapy (CRRT). Continuous veno-venous haemodiafiltration (CVVHDF) was used; the patient remained haemodynamically stable. Flexor responses were seen after 1 1/2 h and the patient regained consciousness within 3 h. There were no complications associated with the procedure except some minor gastric bleeding, which did not need any specific therapy.
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The inspiratory impedance threshold device (ITD) has been shown to improve hemodynamic variables and survival outcomes during cardiopulmonary resuscitation in animals and humans. We hypothesized that use of an ITD, with a resistance of -10 cm H2O, will improve hemodynamics and short-term survival rates during hypovolemic hypotension in spontaneously breathing pigs. ⋯ Use of an ITD improved blood pressure and short-term survival rates in a spontaneously breathing porcine model of hypovolemic hypotension.
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Comparative Study
The effects of teaching basic cardiopulmonary resuscitation--a comparison between first and sixth year medical students.
The purpose of this study was to check if medical students of one of the Universities of Medical Sciences in Poland are prepared to do basic cardiopulmonary resuscitation. The research was undertaken on groups of 50 first year students and 50 sixth year students at the time when they take an exam. To have wider insight into students' ability to perform basic cardiopulmonary resuscitation, quantitative and qualitative methods were used. ⋯ The study showed that skills of ventilation and chest compressions need more practice. The students' own estimation of the ability to perform cardiopulmonary resuscitation both in the first and sixth years is very high, but it does not correlate with their knowledge and skills. Our conclusions indicate the need to improve the programme of teaching cardiopulmonary resuscitation with a refresher course in theory and skills at least once a year.
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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.