Resuscitation
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Randomized Controlled Trial Clinical Trial
The effect of topical non-steroidal anti-inflammatory cream on the incidence and severity of cutaneous burns following external DC cardioversion.
Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a study to determine whether the application of non-steroidal anti-inflammatory cream prior to cardioversion reduces their incidence and severity. ⋯ Prophylactic application of topical ibuprofen 5% cream 2h prior to elective DC cardioversion reduces pain and inflammation. Consideration should be given to use of prophylactic application of topical ibuprofen as routine treatment for elective DC cardioversion.
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To investigate older patients' reasoning for their cardiopulmonary resuscitation (CPR) preferences and the related decision-making process (DMP). ⋯ Older people justify their resuscitation preferences highlighting their experiences of meaningful life or fulfillment of their life, interpersonal relationships with their loved ones and presumed outcome of CPR. Less than a half of the patients wished to discuss CPR and LSTs preferences in their current situation with their physician, but nevertheless wanted to participate in the DMP of end-of-life treatment. Physicians should assess patients' own preferences in-depth.
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Comparative Study
Sex differences in outcome after ventricular fibrillation in out-of-hospital cardiac arrest.
Previous studies have shown that early defibrillation programs improve survival after an out-of-hospital cardiac arrest (OHCA). Reports also suggest that women fare worse than men do after cardiovascular events, but there is no population-based study of sex differences after an OHCA with early defibrillation. We, therefore, compared the short- and long-term survival and quality-of-life (QOL) in women and men after an OHCA. ⋯ Women are more likely to survive to hospital admission following an OHCA. However, admitted women less likely to survive their hospital stay. Long-term survival and QOL are equally favorable in both sexes.
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Comparative Study
The prevalence of recordings of the signs of critical conditions and emergency responses in hospital wards--the SOCCER study.
To estimate the prevalence of recordings in case notes of disturbed physiological variables in adult admissions in general hospital wards. ⋯ There was a high incidence of recordings of disturbed physiological variables in general ward patients. Changes to hospital emergency response systems to include rapidly responding teams to patients with the signs of developing critical conditions should be supported by training programmes for ward staff on the early recognition and management of patients with the warning signs.
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The "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care--International Consensus on Science" recommend a tidal ventilation volume of 10 ml/kg body-weight without the use of supplemental oxygen during two-rescuer adult cardiopulmonary resuscitation (CPR). This relates to a ventilation volume of about 6.4 l/min. Additionally, the first aid provider ventilating the victim will breathe for him/herself during the external chest compression period adding another 3.2 l/min of ventilation. ⋯ Ventilation during two-rescuer CPR performed according to the Guidelines 2000 may cause injury to the health of first aid providers. To minimize hyperventilation, both rescuers should exchange their positions at intervals of 3-5 min. These data challenge the recommendation to take a deep breath prior to each ventilation.