Resuscitation
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This article will describe the access to, and delivery of, emergency medical care in the United Kingdom. We describe how UK Ambulance Services respond to emergency calls and how UK Emergency Departments are configured to provide emergency clinical care. Ambulance technician and paramedic training and clinical skill mix is outlined and UK emergency medicine training and the involvement of doctors in prehospital care is highlighted. We describe the strengths and weaknesses of current Emergency Medical Systems (EMS) in the UK and comment on future areas for improving and developing emergency patient care.
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This is a study of the influence of transthoracic impedance (TTI) on defibrillation, resuscitation and survival in patients with out-of-hospital cardiac arrest (OHCA), treated with a non-escalating impedance-compensating 150 J biphasic waveform defibrillator. ⋯ High impedance patients were defibrillated by the biphasic waveform used in this study at high rates with a fixed energy of 150 J and without energy escalation. Rapid defibrillation rather than differences in patient impedance accounts for resuscitation success.
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Multicenter Study
Long-term outcome of paediatric cardiorespiratory arrest in Spain.
To analyse the final outcome of cardiorespiratory arrest (CRA) in children and the neurological and functional state of survivors at 1 year. ⋯ Prognosis of CRA in children continues to be poor in terms of survival but quite good in terms of neurological and functional status among survivors. Additional strategies and efforts are needed to improve the short-term prognosis of paediatric CRA. However, the long-term outcome of survivors is reassuring.
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Comparative Study
Cerebral density on CT immediately after a successful resuscitation of cardiopulmonary arrest correlates with outcome.
To evaluate whether cerebral CT findings taken immediately after successful resuscitation from cardiopulmonary arrest (CPA) correlate with the outcome or not. ⋯ Although the influence of age cannot be disregarded, the CT number of the putamen and cortex, and also the corticomedullary contrast correlated with outcome of hypoxic encephalopathy even when cerebral CT was performed within 1 h after ROSC following CPA.
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In 1994, all emergency medical services (EMS) ambulance officers in Singapore were trained to perform pre-hospital defibrillation with semi-automated external defibrillators (AED). All non-traumatic cardiac arrest patients over 10 years old were included, excluding those who were obviously dead and children below 36 kg. The data were collected by the ambulance officers according to the Utstein guidelines. ⋯ Our survival rate of bystander witnessed VF/VT arrest is comparable to large metropolitan cities in the USA. The determinants of survival include EMS witnessed arrest and VF/VT arrest. Increased quantity and quality of bystander CPR rate may improve the outcome in bystander witnessed cardiac arrest.