Resuscitation
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The success rate of cardiopulmonary resuscitation (CPR) may differ from institution to institution, even within different sites in the same institution. A variety of factors may influence the outcome. In this study, we assessed the adequacy of CPR attempts guided by the current standards and aimed to define the factors influencing the outcome following in-hospital cardiac arrest. ⋯ Our rates of immediate survival, survival at 24 h and survival to discharge 49.3%, 28.5% and 13.4%, respectively. The extent of monitoring prior to arrest, the attendance of one or more experienced anesthesiologists in the CPR team, CPR during office hours, CPR in ICU or operating room, early initiation of CPR and tracheal intubation prior to arrest were found as the factors increasing discharge survival. We conclude that early initiation of CPR with an experienced team in a well-equipped hospital sites increases the discharge survival rate following cardiac arrest.
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To provide survival rates and associated factors from a 10-year study of in-hospital cardiopulmonary resuscitation (CPR). ⋯ The findings of this study show resuscitation survival rates from a 10-year study and indicate some of the key predictors of survival.
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Review Historical Article
Prehospital management of sarin nerve gas terrorism in urban settings: 10 years of progress after the Tokyo subway sarin attack.
Chemical agents have been used previously in wartime on numerous occasions, from World War I to the Gulf War. In 1994 and 1995, sarin nerve gas was used first in peacetime as a weapon of terrorism in Japan. The Tokyo subway sarin attack was the first large-scale disaster caused by nerve gas. ⋯ All of these therapies may be given simultaneously. This article reviews toxicology and management of this acute chemical emergency. To help minimize the possible catastrophic impact on the public, we make several recommendations based on analysis of the Tokyo subway sarin attack and systematically review the current scientific literature.