Resuscitation
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Comparative Study
Is there a difference between women and men in characteristics and outcome after in hospital cardiac arrest?
To describe the characteristics and outcome among patients suffering from an in-hospital cardiac arrest in women and men. ⋯ Thirty nine percent of patients suffering in-hospital cardiac arrest for whom the CPR-team was alerted, were women. Women were less frequently found in VF/VT than men. After correcting for dissimilarities at baseline, female gender was associated with a small improvement in survival.
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Immediate activation of the emergency medical service (EMS) and cardiopulmonary resuscitation (CPR) increases the incidence of return of spontaneous circulation and the number discharged from hospital. The American Heart Association (AHA) and the European Resuscitation Council describe CPR as an ordinate sequence of eight steps. The objectives of this study were to assess the general knowledge of EMS and CPR and to analyse the retention of the CPR steps 2 months after a Basic Life Support (BLS)-course conducted according to AHA standards. ⋯ HSS were more responsive and receptive than LEA. In order to increase the retention of the sequence of CPR steps, the number of steps should be reduced and refresher courses should be included in training programmes. Early access and early CPR are still not completely effective in the geographical area studied.
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To determine the outcome of patients with out-of-hospital cardiac arrest and ventricular fibrillation as the presenting rhythm while using automated external defibrillators (AEDs) that delivered non-escalating, impedance-compensated low-energy (150 J) shocks. ⋯ Low-energy (150 J) non-escalating biphasic truncated exponential waveform shocks terminate VF in out-of-hospital cardiac arrest with high efficacy; patient outcome is comparable with that observed with escalating high-energy monophasic shocks. Low-energy shocks, in addition to high efficacy, may confer the advantage of less shock-induced myocardial dysfunction, though this will be difficult to define in the clinical circumstance of long-duration VF provoked by a pre-existing diseased myocardial substrate.
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To evaluate the effectiveness of a leadership development seminar introduced into the Resuscitation Council (UK) Advanced Life Support (ALS) Provider course. ⋯ A formal leadership development programme should be introduced into advanced life support courses.
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Six adult cadavers had 40 N cricoid pressure applied using a cricoid 'yoke' whilst maintaining manual in-line stabilisation of the cervical spine. No other spinal supports were used. Lateral radiographs were taken before and after applying pressure to the cricoid cartilage and the degree of cervical spine movement accurately determined. ⋯ There was no disruption to the lines formed by the anterior or posterior borders of the cervical bodies. We have been unable to demonstrate that single-handed cricoid pressure causes clinically significant displacement of the cervical spine in a cadaver model. This conflicts with previous studies.