Resuscitation
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diagnosis of precipitating myocardial infarction is essential for management of victims of out-of-hospital cardiac arrest, since investigations and treatment are determined by the underlying cause. Skeletal muscle and myocardial damage from external cardiac massage and defibrillation may complicate biochemical diagnosis of myocardial infarction. ⋯ skeletal muscle and myocardial damage occurs in survivors of out-of-hospital cardiac arrest and is related to the duration of resuscitation. This complicates biochemical diagnosis of underlying myocardial infarction. Specific high diagnostic threshold values for MB-CK and troponin T are needed to optimise diagnostic accuracy. The use of MB-CK fraction leads to greater diagnostic error because of the variability of muscle CK release after resuscitation.
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to evaluate the efficiency of the first experience in pediatric basic and advanced life support courses in Spain. ⋯ basic and advanced pediatric life support courses are a useful educational method for the general population, health professionals, physicians and nurses in theoretical and practical pediatric resuscitation.
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Comparative Study
A comparison of prolonged manual and mechanical external chest compression after cardiac arrest in dogs.
The effects of manual and a new mechanical chest compression device (Heartsaver 2000) during prolonged CPR with respect to haemodynamics and outcome were tested in a prospective, randomized, controlled experimental trial during ventricular fibrillation in 12 dogs of 9-13 kg body weight after 1 min of cardiac arrest. During the first 10 min of CPR the dogs were resuscitated according to the Basic Life Support (BLS) algorithm, followed by 20 min of Advanced Life Support (ALS) algorithm. After 30 min of CPR both manual and mechanical CPR groups were resuscitated following a standardized ALS protocol. ⋯ The CPR trauma score was less in the mechanical group. Mechanical external chest compression provided better haemodynamics than the manual technique, though outcome did not differ. Both optimally performed manual and mechanical techniques produce flow sufficient to maintain organ viability for 30 min of CPR after a 1 min arrest interval.
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Comparative Study
Comparative assessment of shockable ECG rhythm detection algorithms in automated external defibrillators.
The sensitivity and specificity to ventricular fibrillation (VF) and ventricular tachycardia (VT), classified as requiring immediate DC shock, of four automated external defibrillators (AEDs) and three advisory defibrillators were assessed using the Department of Health Arrhythmia library. This library collected mostly from patients in hospital, includes a wide variety of ECG rhythms including many with additional noise and interference artefact. The library comprised 278 16-s rhythms, 59 of which were VF, 36 were VT requiring cardioversion and 183 were deemed non-shockable. ⋯ All but one of the advisory defibrillators performed similarly. Excluding the artefact rhythms, specificities in the range 79-91% were obtained. All figures stated are at the lower limit of the 95% confidence interval.
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In an attempt to standardize the teaching and training of active compression-decompression cardiopulmonary resuscitation (ACD-CPR), a group of leading emergency physicians, cardiologists, anesthesiologists, paramedics and nurses with practical, theoretical, educational, and scientific experience in the subject met in June 1995. The group was called The International Working Group of Teaching and Training Active Compression-Decompression CPR. The group was 'born' as a result of the first International Conference of Active Compression-Decompression CPR held in Copenhagen in March 1995. The following paper describes the background, development and text of and ACD-CPR course manual for both students and instructors.