Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians.
This prospective randomised study was performed to compare the use of the Esophageal-Tracheal Combitube(R) (ETC; Tyco Healthcare, Mansfield, MA; http://www.combitube.org) with a conventional tracheal airway (ETA) for airway management by experienced physicians of the Emergency Medical Services System of the City of Vienna in the prehospital setting. Access to the patient's head, time of arrival of the ambulance, ease of insertion, time of insertion, potential substitution by the alternate airway, efficacy of adrenaline (epinephrine) administered via the airway, survival to the intensive care unit (ICU) ward and survival to discharge from the hospital were evaluated. One hundred and seventy-two non-traumatic cardiac arrest patients (131 males, 41 females) were enrolled in this study during a 12 months period. ⋯ Both devices served as successful substitutes for each other. Adrenaline (epinephrine) applied via ETC with a 10-fold dosage was as effective as via the conventional ETA. To our knowledge this is the first study using physicians comparing ETC and ETA in the prehospital setting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Improving CPR performance using an audible feedback system suitable for incorporation into an automated external defibrillator.
It has been shown that a computer-based audible feedback system can improve acquisition and retention of basic life support (BLS) skills. This system is being developed to work in association with an automated external defibrillator (AED). ⋯ The results suggest that if the feedback system were to be incorporated into an AED, it could lead to better performance of CPR during a resuscitation attempt.
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Randomized Controlled Trial Clinical Trial
A new universal laryngoscope blade: a preliminary comparison with Macintosh laryngoscope blades.
The Dörges universal laryngoscope blade has several features designed to facilitate tracheal intubation. The number of laryngoscope blades may be reduced from four to two, or even one, which indicate less space requirement and costs. This new universal laryngoscope blade, has a lower profile (height 15 vs. 22 mm) than a Macintosh laryngoscope blade size 3 and 4, which may facilitate manoeuvring of the laryngoscope in the mouth. ⋯ Number of intubation failures, the laryngoscopic view according to Cormack and Lehane, and subjective assessment was comparable between groups. Orotracheal intubation of the adult airway management trainer with the Dörges universal laryngoscope blade took significantly less time compared to the Macintosh laryngoscope blades (14 (7-57) vs. 20 (8-43) s; P<0.001); all other intubating times were comparable. In conclusion, in this model, the Dörges universal laryngoscope blade was comparable to the Macintosh laryngoscope blades size 2-4, and may save time, cost and space.
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The surface electrocardiogram associated with ventricular fibrillation has been of interest to researchers for some time. Over the last few decades, techniques have been developed to analyse this signal in an attempt to obtain more information about the state of the myocardium and the chances of successful defibrillation. This review looks at the implications of analysing the VF waveform and discusses the various techniques that have been used, including fast Fourier transform analysis, wavelet transform analysis and mathematical techniques such as chaos theory.
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Comparative Study
Major bleeding complications in cardiopulmonary resuscitation: the place of thrombolytic therapy in cardiac arrest due to massive pulmonary embolism.
Thrombolytic therapy in patients with massive pulmonary embolism (MPE) and prolonged cardiopulmonary resuscitation (CPR) is subject to debate. This study was performed to determine whether (1) thrombolytic treatment increases the risk of bleeding complications, (2) if the risk of bleeding is influenced by the duration of CPR and if (3) thrombolytic therapy improves outcome. ⋯ Although severe bleeding complications tend to occur more frequently in patients undergoing TL, the benefit of this treatment might outweigh the risk of bleeding.