Resuscitation
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To examine whether induced hypothermia could prolong short-term survival after volume-controlled hemorrhagic shock (HS). ⋯ In lightly anesthetized pigs during volume-controlled HS, induced hypothermia may prolong their short-term survival for reasons that remain to be clarified.
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Randomized Controlled Trial Clinical Trial
Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly.
Bystander cardiopulmonary resuscitation (CPR) increases survival rates. The largest group of cardiac arrest patients are men over the age of 60 in the home, and the most probable potential CPR provider is an older woman who is not likely to have received CPR training. One method to increase the percentage of bystander-initiated CPR in this setting is for CPR instruction to be provided by nurse dispatchers via telephone. ⋯ The median period from dispatcher contact until continuous CPR was significantly longer for standard instructions than for compression only, 4.9 versus 3.4 min, and fewer chest compressions were provided during the 9 min test period, median 124 versus 334 compressions. In both groups the overall CPR performance was of very poor quality, and unlikely to have affected outcome in a real situation. Other telephone assisted CPR scripts should be tested in this potential bystander group.
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Comparative Study
In-hospital factors associated with improved outcome after out-of-hospital cardiac arrest. A comparison between four regions in Norway.
While pre-hospital factors related to outcome after out-of-hospital cardiac arrest (OHCA) are well known, little is known about possible in-hospitals factors related to outcome. ⋯ Both pre-arrest, pre- and in-hospital factors were associated with in-hospital survival after OCHA. It seems important also to report in-hospital factors in outcome studies of OCHA. The design of the study precludes a conclusion on causability.
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The application of percutaneous transtracheal jet ventilation for emergency ventilation depends on special equipment which is often not available outside the operating room. The oxygen flow modulator is a new specially designed device for emergency ventilation using a low pressure oxygen supply. We studied the effects of the new device in comparison with a hand triggered emergency jet injector on oxygenation and ventilation in six pigs (21+/-1 kg). ⋯ After each phase of the experiment respiratory and hemodynamic variables were measured. Whereas PaO(2) was not significantly different between the two devices, PaCO(2) was higher during the hand-triggered jet ventilation. Thus, the efficacy of the oxygen flow modulator during the experiment was comparable with the efficacy of the hand triggered emergency jet injector.
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The in-hospital Utstein template for cardiopulmonary resuscitation (CPR) was assessed in four secondary hospitals (334-441 beds) which did not have systematic data collection. ⋯ The in-hospital Utstein template was logical but laborious and it provided tools for resuscitation management evaluation in the study hospitals. For continuous use, a slightly compressed model may be warranted. In the present material, the overall survival rate to hospital discharge was in line with previous reports but there were somewhat less neurologically satisfactory survivors. There is an evident need to improve the outcome of patients suffering CA on the wards. An important step is to reduce the time interval to defibrillation.