Resuscitation
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The Resuscitation Council (UK) Advanced Life Support (ALS) Course is a multidisciplinary training course which teaches participants how to manage the resuscitation of a patient at risk of or in cardiac arrest. To reduce variability in assessments, four standardised patient scenarios have been developed with common performance criteria. The aim of the study was to establish how much candidates remembered about their test in order to assess the potential for collusion. ⋯ However, even in this group, the overall recall of all elements of the scenario was correct in only 49% of instances. This study demonstrated that immediately after testing candidates had good recall of the initial clinical scenario with which they were presented, but poor recall of cardiac arrest rhythms during the simulated resuscitation attempt. These findings provide some reassurance that the likelihood of successful collusion improving subsequent candidates performance is likely to be small as recall of the scenario progression is limited.
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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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Comparative Study
Quadriphasic waveforms are superior to triphasic waveforms for transthoracic defibrillation in a cardiac arrest swine model with high impedance.
We have demonstrated previously that triphasic waveform shocks were superior to biphasic waveform shocks for transthoracic defibrillation. Our purpose was to compare the efficacy and safety of quadriphasic versus triphasic shocks for transthoracic defibrillation in a porcine model. ⋯ In this porcine model, 20 ms (5/5/5/5) quadriphasic shocks were superior to 15 ms (5/5/5) triphasic shocks for transthoracic defibrillation in animals with impedances that simulated high impedance in humans.
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To discover design principles underlying the optimal waveforms for external chest and abdominal compression and decompression during cardiac arrest and cardiopulmonary resuscitation (CPR). ⋯ Optimized waveforms for thoraco-abdominal compression and decompression include previously discovered features of active decompression and interposed abdominal compression. These waveforms can be used by manual (Lifestick-like) and mechanical (vest-like) devices to achieve short periods of near normal blood perfusion non-invasively during cardiac arrest.
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Comparative Study
The effect of global hypoxia on myocardial function after successful cardiopulmonary resuscitation in a laboratory model.
Most laboratory studies of cardiac arrest use models of ventricular fibrillation, but in the emergency room, operating room or intensive care unit, cardiac arrest frequently results from asphyxia. We sought to investigate the effect of different durations of asystole secondary to asphyxia on myocardial function after resuscitation. In a laboratory based experimental series, anaesthetized rats received either 4 or 8 min of asphyxial cardiac arrest, and following standardized resuscitation, serial transthoracic echocardiography was performed. ⋯ Increased duration of asphyxia causes increased systolic and diastolic dysfunction. These findings may have significant implications for resuscitative therapeutics. ECHO assessment may permit specific targeting of therapy directed towards systolic or diastolic function during CPR.