Resuscitation
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The in-hospital Utstein Style was published in April 1997. This new format is used to present the outcome of in-hospital cardiac arrest in Middlemore Hospital, Auckland, NZ, between June 1995 and June 1996. ⋯ Forty-seven patients had ROSC greater than 24 h, 35 were discharged alive and 30 were alive at 1 year. Of these 30 survivors, 27 had a Cerebral Performance Category of 1.
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To evaluate the effectiveness of inhalation rewarming in early resuscitative efforts for hypothermic victims. ⋯ The safety and efficacy of inhalation rewarming suggest that it is a viable adjunct of treatment during hypothermic resuscitation. Its routine use may be more appropriate for a field rescue situation where more advanced rewarming modalities may not be available or practicable. Also, its primary value may be to minimize further core temperature loss during early management of accidental hypothermia.
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To evaluate resuscitation efforts for patients with cardiac and/or pulmonary arrest in our hospital a retrospective study was conducted and compared with available data from other community teaching hospitals. Records of 131 consecutive patients of ages 16-98 who received resuscitation according to Advanced Cardiac Life Support protocols were reviewed. Short-term survival (return of spontaneous circulation) and discharge-from-the hospital survival were measured. ⋯ Post-bypass surgery patients had a better survival than non-surgical patients, but the difference was significant (P > 0.05). Survival in our hospital was comparable to one hospital and worse than another (34.8% vs. 39.6% or 63.0%). Despite success, prognosis after arrest remain poor.
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Randomized Controlled Trial Comparative Study Clinical Trial
Four-step CPR--improving skill retention.
This study is an attempt to see if simplifying the teaching of basic life support leads to better skill acquisition and retention. Forty-eight lay volunteers received instruction in CPR; 24 were taught the standard 8-step sequence whereas 24 were taught a simplified 4-step sequence. Tests of performance were carried out on a manikin before and after training. ⋯ There was no difference, however, in the quality of performance of the skills between the two groups. In addition, it was shown that use of the 4-step sequence should result in a useful reduction in the time taken before a rescuer calls for the emergency services and commences CPR. Whether such a radical change in teaching should be introduced is a matter for further discussion and research.
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The aim of the study was to evaluate whether mass-mailing of a 12-month wall calendar which focused on child and infant safety and first aid treatment had any educational effect on lay people. The calendar included algorithms for removal of a foreign body from the airways and infant and child CPR. The knowledge and skills in these procedures were tested in two groups using a previously validated check-list before and after the introduction of the calendar. ⋯ Whether the test persons had children 0-8 years old or not, did not affect the results. In conclusion the calendar had no educational effect when distributed by mail, but a safety campaign which included distribution of the calendar and a possibility to borrow a manikin had a positive influence on the first aid skills and knowledge of lay people. Mass mailing of CPR or other first aid material free-of-charge does not seem to further the goal of increasing the rate and proficiency of bystander interventions to save lives.