Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2010
A first city-wide early defibrillation project in a German city: 5-year results of the Bochum against sudden cardiac arrest study.
Immediate defibrillation is the decisive determinant of prognosis in patients suffering from cardiac/circulatory arrest caused by ventricular fibrillation (VF). Therefore, various national and international associations recommend that first responders use defibrillators as soon as possible and also recommend public access to early defibrillation programmes. Here we report the results of the first city-wide early defibrillation project in a large German urban area. ⋯ Consistent with other reports, our findings show that the organisation of a city-wide initiative by a project office combining public access and first-responder defibrillation programmes can be safe, feasible and successful. Our experiences confirm that strategic planning of AED placement is a prerequisite for successful, cost-effective resuscitation.
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Scand J Trauma Resus · Jan 2010
Editorial CommentContinuous chest compressions: encouraging but unusual.
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Scand J Trauma Resus · Jan 2010
Randomized Controlled TrialAdvanced Cardiac Resuscitation Evaluation (ACRE): a randomised single-blind controlled trial of peer-led vs. expert-led advanced resuscitation training.
Advanced resuscitation skills training is an important and enjoyable part of medical training, but requires small group instruction to ensure active participation of all students. Increases in student numbers have made this increasingly difficult to achieve. ⋯ The key elements of advanced cardiac resuscitation can be safely and effectively taught to medical students in small groups by peer-instructors who have undergone basic medical education training.
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Scand J Trauma Resus · Jan 2010
2-year survival of patients undergoing mild hypothermia treatment after ventricular fibrillation cardiac arrest is significantly improved compared to historical controls.
Therapeutic hypothermia has been proven to be effective in improving neurological outcome in patients after cardiac arrest due to ventricular fibrillation (VF). Data concerning the effect of hypothermia treatment on long-term survival however is limited. ⋯ Our study demonstrates that the early survival benefit seen with therapeutic hypothermia persists after two years. This strongly supports adherence to current recommendations regarding postresuscitation care for all patients after cardiac arrest due to VF and maybe other rhythms as well.
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Scand J Trauma Resus · Jan 2010
Comparative Study Clinical TrialEffect of hyperbaric oxygen therapy on whole blood cyanide concentrations in carbon monoxide intoxicated patients from fire accidents.
Hydrogen cyanide (HCN) and carbon monoxide (CO) may be important components of smoke from fire accidents. Accordingly, patients admitted to hospital from fire accidents may have been exposed to both HCN and CO. Cyanide (CN) intoxication results in cytotoxic hypoxia leading to organ dysfunction and possibly death. While several reports support the use of hyperbaric oxygen therapy (HBO) for the treatment of severe CO poisoning, limited data exist on the effect of HBO during CN poisoning. HBO increases the elimination rate of CO haemoglobin in proportion to the increased oxygen partial pressure and animal experiments have shown that in rats exposed to CN intoxication, HBO can increase the concentration of CN in whole blood. ⋯ CN concentrations in blood from patients admitted to hospital with CO intoxication and smoke inhalation exposure did not differ significantly from controls. Accordingly, we were not able to detect any changes in CN concentrations in blood after treatment with HBO.