Resuscitation
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Review Randomized Controlled Trial Clinical Trial
The Public Access Defibrillation (PAD) trial: study design and rationale.
The PAD Trial is a prospective, multicenter, randomized clinical study testing whether volunteer, non-medical responders can improve survival from out-of-hospital cardiac arrest (OOH-CA) by using automated external defibrillators (AEDs). These lay volunteers, who have no traditional responsibility to respond to a medical emergency as part of their primary job description, will form part of a comprehensive, integrated community approach to the treatment of OOH-CA. The study is being conducted at 24 field centers in the United States and Canada. ⋯ The primary endpoint is the number of OOH-CA victims who survive to hospital discharge. Secondary endpoints include neurological status, health-related quality of life (HRQL), cost, and cost-effectiveness. Data collection will last approximately 15 months and is expected to be completed in September 2003.
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of a defibrillator-basic cardiopulmonary resuscitation programme for non medical personnel.
To improve the outcome for out-of-hospital patients with ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), the use of automated external defibrillators (AEDs) by first responders including non-medical personnel with a duty to respond to an emergency is recommended. A special CPR-AED course has been developed. We wanted to test the results (quality and speed of operating an AED and CPR) after completion of such a course and retention after approximately 1-year. ⋯ The retention group had a lower frequency of correct inflations than the pre-course group, and the post-course group the highest number of correct ventilations per minute. These findings suggest that use of an AED by untrained laypersons may be feasible and that complex and time-consuming training programmes may not be necessary. The present study also supports the need for annual training and recertification.
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Comparative Study
Public access defibrillation in Helsinki--costs and potential benefits from a community-based pilot study.
In cardiac arrest the interval between the collapse and defibrillation may be shortened by teaching lay people to use defibrillators. We conducted a 3-year prospective, community-based study on public access defibrillation (PAD) in an urban emergency medical services system. All public sites with a cardiac arrest incidence of at least one per year were equipped with automated external defibrillators. ⋯ The direct costs were 110,270 Eur and only 13.5-16% of this figure would be related to the cost of defibrillators during their 8 years lifespan. This study showed that a community based model of PAD shortens the time to CPR and defibrillation significantly in an urban environment but various challenges have to be solved before wider implementation of PAD. In future projects the nature of the costs especially should be considered.
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Comparative Study
Lunar phases are not related to the occurrence of acute myocardial infarction and sudden cardiac death.
Mass media deliver pertinacious rumours that lunar phases influence the progress and long-term results in several medical procedures. Peer reviewed studies support this, e.g. in myocardial infarction, others do not. ⋯ Lunar phases do not appear to correlate with acute coronary events leading to myocardial infarction or sudden cardiac death.
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Comparative Study
LF 16-0687 Ms, a new bradykinin B2 receptor antagonist, decreases ex vivo brain tissue prostaglandin E2 synthesis after closed head trauma in rats.
Bradykinin (B) contributes to secondary brain injury. This injury is mediated in part by prostaglandin (PG). Antagonism of B(2) receptors improves neurological status after brain injury, but the effect of B(2) antagonism on brain tissue PG is unknown. This study examined the effect of LF 16-0687 Ms, a new B(2) receptor antagonist, on brain tissue PGE(2) after closed head trauma (CHT). ⋯ We conclude that the beneficial effect of LF 16-0687 Ms on outcome after CHT is accompanied by blockade of PGE(2) increase in injured brain tissue.