Resuscitation
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Ambulance crews may alert hospitals for patients who are severely unwell. This allows the hospital time to prepare space and equipment, and to assemble an appropriate clinical team to receive and manage the patient immediately on arrival. Over and under alerting by ambulance crews is to be avoided to avoid complacency on one hand, and inadequate reception of severely injured patients on the other. There are currently no formal guidelines for the ambulance service to alert hospitals in appropriate cases. ⋯ The majority of patients with major trauma (ISS > 15) were not the subject of a hospital alert by the ambulance service. Seventy-five percent of the patients who were the subject of an alert were not eligible for inclusion into TARN, implying that they did not have serious injury. Pre-hospital trauma severity assessment needs developing with appropriate ambulance protocols, to ensure appropriate alert calls.
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Randomized Controlled Trial Comparative Study Clinical Trial
Determination of heart rate in the baby at birth.
The International Liaison Committee on Resuscitation (ILCOR) publishes guidelines on neonatal resuscitation, which are evidence-based where possible. Initial assessment of heart rate, breathing and colour is an essential part of newborn resuscitation and the guidelines state that heart rate may be assessed using a stethoscope, or palpating the umbilical, brachial or femoral pulse. This study aimed to assess the most effective method(s) of heart rate assessment in the newborn baby. ⋯ Umbilical pulsations must not be relied upon if low or absent. In assessing heart rate in newborn resuscitation only the stethoscope is likely to be completely reliable. In the absence of a stethoscope only the umbilical pulse should be used with an awareness of its limitations.
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Comparative Study
Is female sex associated with increased survival after out-of-hospital cardiac arrest?
To evaluate survival after out-of-hospital cardiac arrest in relation to sex. ⋯ Among patients suffering out-of-hospital cardiac arrest in Sweden which was not crew witnessed and in whom resuscitation efforts were attempted, female sex was associated with an increased survival.