Resuscitation
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The recommended treatment for severe hypothermia with circulatory collapse is re-warming using cardiopulmonary by-pass. This may require transporting a patient to hospital with on-going cardiopulmonary resuscitation (CPR). Manual CPR during patient transport may result in sub-optimal chest compressions and can be a hazard for the ambulance crew. ⋯ During cardiopulmonary by-pass ROSC was achieved after 90 min of cardiac arrest. The patient recovered with a cerebral performance category of 3. Using a mechanical device for chest compressions during transport of a hypothermic patient with on-going CPR is feasible, effective and safe.
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We report a case in which mild therapeutic hypothermia was used successfully in a patient with coma after cardiorespiratory arrest induced by hanging.
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Comment Letter Comparative Study
Determining accurate call-to-shock times is easy.
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Review Comparative Study
Incidence of EMS-treated out-of-hospital cardiac arrest in Europe.
The potential impact of efforts in Europe to improve survival from out-of-hospital cardiac arrest is unclear, in part, because estimates of incidence and survival are uncertain. The aim of the investigation was to determine a representative European incidence and survival from cardiac arrest in all-rhythms and in ventricular fibrillation treated by the emergency medical services (EMS). ⋯ The results provide a framework to assess opportunities and limitations of EMS care with regard to the public health burden of cardiac arrest in Europe.
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Randomized Controlled Trial Comparative Study
Effectiveness of a 30-min CPR self-instruction program for lay responders: a controlled randomized study.
The length of current 4-h classes in cardiopulmonary resuscitation (CPR) is a barrier to widespread dissemination of CPR training. The effectiveness of video-based self-instruction (VSI) has been demonstrated in several studies; however, the effectiveness of this method with older adults is not certain. Although older adults are most likely to witness out-of-hospital cardiac arrests, these potential rescuers are underrepresented in traditional classes. We evaluated a VSI program that comprised a 22-min video, an inflatable training manikin, and an audio prompting device with individuals 40-70 years old. The hypotheses were that VSI results in performance of basic CPR skills superior to that of untrained learners and similar to that of learners in Heartsaver classes. ⋯ Older adults learned the fundamental skills of CPR with this training program in about half an hour. If properly distributed, this type of training could produce a significant increase in the number of lay responders who can perform CPR.