Resuscitation
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This post-market, observational study is intended to evaluate reported uses of pediatric pads that reduce the energy delivered by some adult automated external defibrillators (AEDs) so that they may be used with pediatric patients. ⋯ Voluntary reports of the use of attenuated pediatric defibrillation pads indicate the devices performed appropriately. All eight VF patients had termination of VF and five survived to hospital discharge. These data support the rapid deployment of AEDs for young children as well as adolescents and adults. Since the pediatric pads are available and deliver an appropriate dose for children, their use should be strongly encouraged.
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In out-of-hospital emergencies, including cardiac arrest, securing the airway and providing adequate lung ventilation are of paramount importance. Tracheal intubation is perceived as the gold standard technique and it is recommended by International Guidelines, but non skilled personnel often find the procedure difficult to achieve. Supraglottic devices are a good alternative in these situations, because they are superior to a bag-valve-mask for lung ventilation and offer better protection from aspiration. ⋯ The laryngeal tube remained in the correct position throughout resuscitation attempts in 93.3% of cases, while in two patients (6.6%) it became dislodged. In a subjective evaluation of the manoeuvre by nurses (ease of insertion, adequacy of ventilation, protection from aspiration), 86.7% of them expressed a positive opinion. The laryngeal tube appeared to be a reliable device for nurses to manage the airway in out-of-hospital emergencies.
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The purpose of this study is to examine the commonly held assumption that time is measured and documented accurately during resuscitation from cardiac arrest in the hospital. ⋯ Missing time data, negative calculated Utstein gold-standard process intervals, unlikely intervals of 0 min from arrest recognition to ALS interventions in units with CPR providers only, use of multiple timepieces for recording time data during the same event, and wide variation in coherence and precision of timepieces bring into question the ability to use time intervals to evaluate resuscitation practice in the hospital. Practitioners, researchers and manufacturers of resuscitation equipment must come together to create a method to collect and document accurately essential resuscitation time elements. Our ability to enhance the resuscitation process and improve patient outcomes requires that this be done.
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Comparative Study
A comparison of CPR delivery with various compression-to-ventilation ratios during two-rescuer CPR.
The number of chest compressions required for optimal generation of coronary perfusion pressure remains unknown although studies examining compression-to-ventilation ratios higher than 15:2 (C:V) in animals have reported higher C:V to be superior for return of spontaneous circulation and neurologic outcome. We examined human performance of two-rescuer CPR using various C:V. ⋯ A 15:2 compression-to-ventilation ratio when performed during two-rescuer CPR results in 26s of hands off time each minute while only delivering 60 compressions. Alternative C:V ratios of 30:2, 40:2, 50:2, and 60:2 all exceed the AHA recommended 80 compressions/min while still delivering a minute volume in excess of 1l.