Resuscitation
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Case Reports
Beneficial effects of vasopressin in prolonged pediatric cardiac arrest: a case series.
Children who suffer cardiac arrest have a poor prognosis. Based on laboratory animal studies and clinical data in adults, vasopressin is an exciting new vasopressor treatment modality during cardiopulmonary resuscitation (CPR). In particular, vasopressin has resulted in short term resuscitation benefits as a "rescue" pressor agent in the setting of prolonged out-of-hospital CPR for ventricular fibrillation in adults. ⋯ Two of four vasopressin recipients survived >24 h; one survived to hospital discharge and one had withdrawal of supportive therapies following family discussion. Our observations are AHA level 5 (retrospective case series) evidence that vasopressin administration may be beneficial during prolonged pediatric cardiac arrest. Such reports should pave the way for prospective clinical trials comparing vasopressor medications in the setting of pediatric cardiac arrest.
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To investigate the mode of cardiac arrest in patients with acute myocardial infarction attended by general practitioners, and the effectiveness of early defibrillation. ⋯ All those who provide the initial care for this vulnerable group of patients should be equipped with defibrillators. The more widespread deployment of defibrillators in the community may be a successful strategy for reducing unnecessary deaths from coronary heart disease.
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Comparative Study
Estimated cost effectiveness of a police automated external defibrillator program in a suburban community: 7 years experience.
To estimate the cost effectiveness of a 7-year police automatic external defibrillator (AED) program in four suburban communities. ⋯ Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.
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The outcome from in-hospital cardiac arrest has improved little since the implementation of cardiopulmonary resuscitation 40 years ago. Early defibrillation improves survival following ventricular fibrillation and pulseless ventricular tachycardia. The emergence of automatic external defibrillators and advisory defibrillators has been heralded as the answer to defibrillation delays in-hospital. ⋯ There is limited primary research evaluating automatic external defibrillators in-hospital. Manual defibrillators remain the most commonly used device for in-hospital defibrillation. Automated external defibrillators offer an alternative to manual defibrillation providing they have a screen and manual override capability, and the technology for pacing is close to hand. For in-hospital automatic external defibrillator programmes to be effective a change in nursing philosophy must occur, and defibrillation must become an expected rather than an extended nursing role.