MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Resuscitation' source. Wed, 08 Feb 2012 14:35:39 +0100 http://www.medworm.com/index.php?rid=5660329&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211007362%2Fabstract%3Frss%3Dyes Where exactly is the chest compression, where does it begin, when does it end, how deep does it go and at what rate are they performed? In short – how good or bad is the chest compression? These are some of the questions researchers ask themselves repeatedly. As well as these data, we need to know the proportion of resuscitation time spent giving quality compressions, the ratio of interruptions and several other parameters and we need to evaluate the effect on survival. Considering the increasing capacity for data storage and growing repositories of resuscitation data one might also ask what proportion of valuable research time is spent in analysing compressions. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660329 Fri, 30 Dec 2011 05:00:00 +0100 5660329 http://www.medworm.com/index.php?rid=5660333&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006988%2Fabstract%3Frss%3Dyes Comprehensive post-resuscitation care and the implementation of therapeutic hypothermia (TH) have improved survival and neurological recovery in comatose victims of cardiac arrest (CA). Changes in the management of post-CA coma have also considerably modified outcome prognostication in a way that an increasing number of patients may awake from post-CA coma despite early clinical signs of severe secondary hypoxic–ischemic brain damage. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660333 Mon, 19 Dec 2011 05:00:00 +0100 5660333 http://www.medworm.com/index.php?rid=5660332&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006976%2Fabstract%3Frss%3Dyes Until recently, cardiopulmonary resuscitation (CPR) has represented the only method to support life in cardiac arrest. During CPR, artificial circulation is produced by chest compression while pulmonary function is supported by positive pressure ventilation. Basic CPR techniques can be taught to everyone and used by everyone, which has enabled thousands of lives to be saved worldwide. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660332 Mon, 19 Dec 2011 05:00:00 +0100 5660332 http://www.medworm.com/index.php?rid=5505721&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006691%2Fabstract%3Frss%3Dyes (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505721 Fri, 16 Dec 2011 07:38:40 +0100 5505721 http://www.medworm.com/index.php?rid=5505682&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006502%2Fabstract%3Frss%3Dyes This issue of Resuscitation contains several outstanding articles addressing the use of intraosseous (IO) devices for vascular access during resuscitation of adults. The volume and quality of investigations and analyses concerning adult IO in recent years has been extraordinary, with the current works as outstanding examples. Those advocating the use of IO have focused on the technical advantages, such as ease of insertion and time to drug administration, while citing generally favourable pharmacodynamic comparisons with peripheral intravenous (IV) and central venous routes. When considering the impact of these efforts, it is worth stepping back to consider their broader context as well as the limitations of our current understanding regarding optimal resuscitation. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505682 Fri, 16 Dec 2011 07:38:40 +0100 5505682 http://www.medworm.com/index.php?rid=5505681&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006472%2Fabstract%3Frss%3Dyes Following the publication in 2010 of the International Liaison Committee on Resuscitation (ILCOR) Consensus on Cardiopulmonary Resuscitation (CPR) Science with Treatment Recommendations (CoSTR) and the European Resuscitation Council (ERC) Guidelines, the Resuscitation editorial team was expecting a relatively quiet 2011. Instead, we are delighted to report a substantial increase in the number and, more importantly, the quality of submissions to the journal. Here we summarise briefly the key papers published in Resuscitation in 2010. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505681 Fri, 16 Dec 2011 07:38:40 +0100 5505681 http://www.medworm.com/index.php?rid=5660331&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006915%2Fabstract%3Frss%3Dyes In this edition of Resuscitation Kalmar et al. present a novel method of detecting oesophageal intubation based on ventilation pressure waveforms. The arguments for tracheal intubation in emergency care, and the disastrous consequences of accidental intubation of the oesophagus, are well documented. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660331 Fri, 16 Dec 2011 05:00:00 +0100 5660331 http://www.medworm.com/index.php?rid=5660362&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006320%2Fabstract%3Frss%3Dyes The recent editorial ‘Pauses during CPR—Are breaks hindering our efforts?’ indicated incorrectly that the study by Hoppu and colleagues was undertaken in Helsinki. In fact, this research was undertaken in Turku and Tampere and was not connected with Helsinki. I apologise to these authors for overlooking this error and for any offence caused.Jerry NolanEditor-in-Chief (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660362 Wed, 30 Nov 2011 05:00:00 +0100 5660362 http://www.medworm.com/index.php?rid=5660358&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006447%2Fabstract%3Frss%3Dyes Rescuers often fail to recognize cardiac arrest. This causes a delay in starting cardiopulmonary resuscitation (CPR) and this decreases the victim's chances of survival. A common reason for not starting CPR is the presence of a period of agonal breathing (gasping) after the heart stops. This is often mistaken for normal breathing. Training rescuers to recognize the signs of cardiac arrest using inanimate manikins is difficult. The use of video clips from actual arrests raises ethical issues about consent, and trainees may also find these real videos disturbing. Actors role playing cardiac arrest victims are not always realistic. Animation offers an alternative approach to teaching the recognition of cardiac arrest. A project by second and third year students at the Bristol School of Animat... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660358 Wed, 23 Nov 2011 05:00:00 +0100 5660358 http://www.medworm.com/index.php?rid=5401136&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005818%2Fabstract%3Frss%3Dyes The crucial inter-relationship between time to interventions and survival following cardiac arrest is well established. Time to act following onset of chest pain, time to commencement of cardiopulmonary resuscitation (CPR), time to defibrillation for shockable rhythms, time to advanced life support and timing of post resuscitation care are all key system factors that contribute to improve survival. The effectiveness of many of these interventions relies on how quickly the emergency medical services (EMS) are activated in response to confirmed or suspected cardiac arrest in the community. The need for early activation of the EMS is well identified within the basic life support algorithm in many national resuscitation councils worldwide and by ILCOR. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401136 Sun, 13 Nov 2011 07:24:48 +0100 5401136 http://www.medworm.com/index.php?rid=5660357&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006101%2Fabstract%3Frss%3Dyes We welcome the thoughtful response by Aldous et al. to our recent publication in Resuscitation and the presentation of some new evidence with regard to this fascinating biomarker. We agree that the analytical characteristics of the Alere troponin I assay (with particular regard to precision) do not compare favourably with some of the other contemporary assays. The advantages of the Alere troponin I and heart fatty acid binding protein (H-FABP) assays are their availability as automated immunoassays for use at the point of care. This enables a more rapid turnaround time, which is ideal for use in the emergency department. Alere has recently developed a more sensitive troponin I assay, which warrants prospective evaluation. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660357 Thu, 10 Nov 2011 05:00:00 +0100 5660357 http://www.medworm.com/index.php?rid=5660339&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006228%2Fabstract%3Frss%3Dyes Abstract: Objective: To assess the role of percutaneous cardiopulmonary support (PCPS) for the resuscitation of patients with massive pulmonary embolism (PE) with circulatory collapse. We also compared outcomes for PCPS between patients with massive PE with circulatory collapse and patients with AMI with cardiogenic shock.Background: The effectiveness of PCPS for acute myocardial infarction (AMI) complicated with cardiogenic shock has been reported, but there are few reports on the use of PCPS for massive PE with circulatory collapse.Method: We studied 12 consecutive patients with massive PE and 16 patients with AMI, who required PCPS for resuscitation either during cardiopulmonary resuscitation (CPR) or after successful CPR.Results: Twelve patients with PE and 16 patients with AMI were id... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660339 Mon, 07 Nov 2011 05:00:00 +0100 5660339 http://www.medworm.com/index.php?rid=5660337&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006289%2Fabstract%3Frss%3Dyes Abstract: Aims: High quality cardiopulmonary resuscitation (CPR) plays an important role in survival of out-of-hospital cardiac arrests (OHCAs). We have developed an algorithm to automatically identify the quality of chest compressions from data retrieved from automatic external defibrillators (AEDs).Methods: Electrocardiographic (ECG) signals retrieved from AEDs were analyzed by a newly developed algorithm to identify fluctuations in CPR. The algorithm contained three steps. First, it decomposed the AED signals into several intrinsic mode fluctuations (IMFs) by empirical mode decomposition (EMD). Second, it identified the dominant IMFs that carried the chest compression signals and weighted the IMFs to both enhance the chest compression oscillations and filter the noise. Third, it calcula... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660337 Mon, 07 Nov 2011 05:00:00 +0100 5660337 http://www.medworm.com/index.php?rid=5505686&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100623X%2Fabstract%3Frss%3Dyes “Bench-to-bedside translational research” is the current buzz phrase. The translation of basic research knowledge to effective clinical treatment is the Holy Grail of biomedical research, and more broadly, “essential to the public good”. Appropriate and humane animal-based research is indispensable to much of clinical research, and is recognised as such by the Declaration of Helsinki, and by funding agencies such as US National Institute for Health (NIH). Animal models serve as useful tools for reproducing a wide variety of clinical conditions, and as ‘controlled platforms’ for testing the feasibility, efficacy, and safety of therapeutic interventions. Knowledge generated by research on animals has led to important advances in understanding the pathophysiology of various diseas... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505686 Mon, 07 Nov 2011 05:00:00 +0100 5505686 http://www.medworm.com/index.php?rid=5505684&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006241%2Fabstract%3Frss%3Dyes Although one of the major goals of resuscitation is maintaining end organ perfusion, to date there have been no standard real-time clinical methods available to determine effective brain perfusion. While the electroencephalogram (EEG) has been used to assess cerebral ischaemia, it does not provide a real-time measure of oxygen delivery to the brain and cannot be used reliably in clinical practice. Recently, a small portable EEG device using bispectral technology (BIS Monitoring – Aspect Medical Systems, Norwood, MA, USA) has been studied in cardiac arrest; however, it was found to be susceptible to movement artifact and is therefore unreliable. Another non-invasive technology that has emerged, which is not susceptible to motion artifact, is cerebral oximetry using near infrared spectrosc... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505684 Mon, 07 Nov 2011 05:00:00 +0100 5505684 http://www.medworm.com/index.php?rid=5505683&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006253%2Fabstract%3Frss%3Dyes One size does not fit all in the management of cardiac arrest. Although the basic life support algorithm provides a generic approach to cardiac arrest management, a treatment strategy tailored according to aetiology at all stages in the chain of survival has the potential to improve survival. Determining the aetiology of a cardiac arrest and tailoring therapy accordingly usually only commences with the arrival of trained assistance, generally delivering advanced life support. The idea of tailoring basic life support according to the aetiology has not yet found its way into clinical practice because the initial responder is usually an untrained bystander with little or no medical knowledge. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505683 Mon, 07 Nov 2011 05:00:00 +0100 5505683 http://www.medworm.com/index.php?rid=5660356&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006113%2Fabstract%3Frss%3Dyes In the August issue of Resuscitation, Body et al. concluded that a combination of heart fatty acid binding protein (hFABP) and cardiac troponin could rule out acute myocardial infarction (AMI) with a sensitivity of 82.2% overall and 96.9% in low risk patients. hFABP has previously been shown to be an early marker of myocardial damage but is unsuitable as a test for patients presenting >6h from onset of symptoms due to rapid renal clearance. However, the troponin assays used in the above paper for adjudication (Roche troponin T) and as an index test (Alere troponin I) and in previous publications have been relatively insensitive assays. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660356 Fri, 04 Nov 2011 04:00:00 +0100 5660356 http://www.medworm.com/index.php?rid=5505685&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006149%2Fabstract%3Frss%3Dyes Medical errors and adverse events are alarmingly frequent in hospital. A systematic review has found that one in eleven patients suffer at least one adverse event during their hospital stay. Many of these events have minor consequences but about one in fourteen are fatal. The emergency setting is particularly prone to errors and adverse events, relating to the time-critical, high-impact decision making that is required of the emergency responders, often made up of an ad-hoc team. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505685 Fri, 04 Nov 2011 04:00:00 +0100 5505685 http://www.medworm.com/index.php?rid=5660360&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100606X%2Fabstract%3Frss%3Dyes We read with great interest the article by Fang et al. about the ultrastructural changes observed in the myocardium of rats submitted to ventricular fibrillation and cardiopulmonary resuscitation (CPR). (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660360 Thu, 03 Nov 2011 04:00:00 +0100 5660360 http://www.medworm.com/index.php?rid=5660355&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006083%2Fabstract%3Frss%3Dyes We appreciate the letter by Paal et al. in response to our recent paper. The main finding of our study was that mouth-to-mouth ventilation reduces interruptions in chest compressions and results in a higher proportion of effective ventilations compared to mouth-to-pocket mask ventilation and bag-valve-mask ventilation. Mouth-to-mouth ventilation resulted in improved quality of cardiopulmonary resuscitation (CPR). (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660355 Thu, 03 Nov 2011 04:00:00 +0100 5660355 http://www.medworm.com/index.php?rid=5660354&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006071%2Fabstract%3Frss%3Dyes We read with interest the article of Adelborg et al. where lifeguards performed single rescuer cardiopulmonary resuscitation (CPR) in a simulated manikin scenario. Mouth-to-mouth ventilation resulted in reduced interruptions of chest compressions and a higher proportion of effective ventilations when compared to mouth-to-mask or bag-valve mask ventilation. The authors concluded that in this simulated single rescuer scenario CPR quality improved with mouth-to-mouth when compared to mouth-to-mask and bag-valve mask ventilation. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660354 Thu, 03 Nov 2011 04:00:00 +0100 5660354 http://www.medworm.com/index.php?rid=5505692&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006150%2Fabstract%3Frss%3Dyes Abstract: Aim To investigate the association between regional brain oxygen saturation (rSO2) on hospital arrival and neurological outcomes at hospital discharge in patients with out-of-hospital cardiac arrest (OHCA).Methods A prospective cohort study was conducted, registering 179 patients with OHCA who were referred to Senri Critical Care Medical Centre between April 2009 and June 2010. Of these patients, 92 met the inclusion criteria. The primary end point was “neurological outcomes” at hospital discharge according to the “Utstein style” guidelines.Results The overall rate of good neurological outcome at hospital discharge was 14% (n=13). Sixty-one patients with rSO2 ≤25% showed poor neurological outcome in the receiver operating curve analysis (optimal cut-off point, 25%; sens... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505692 Wed, 02 Nov 2011 04:00:00 +0100 5505692 http://www.medworm.com/index.php?rid=5660338&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006058%2Fabstract%3Frss%3Dyes Abstract: Background: Emergency endotracheal intubation results in accidental oesophageal intubation in up to 17% of patients. This is frequently undetected thereby adding to the morbidity and mortality. No current method to detect accidental oesophageal intubation in an emergency setting is both highly sensitive and specific. We hypothesized that, based on differences between the mechanical properties of the oesophagus and the trachea/lung, ventilation pressures could discriminate between tracheal and oesophageal intubation. Such a technique would potentially not suffer some of the limitations of current methods to detect oesophageal intubation in emergency conditions such as noisy environment (making clinical assessment difficult) or low/no flow states (reducing the applicability of capn... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660338 Mon, 31 Oct 2011 04:00:00 +0100 5660338 http://www.medworm.com/index.php?rid=5660336&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006034%2Fabstract%3Frss%3Dyes Abstract: Standard hospital CPR policies in many countries require CPR to be attempted on all patients having a cardiac arrest unless a Not-for-CPR order is in place. It has recently been shown that this approach is legally inappropriate in New Zealand. It appears that this argument may also potentially apply in other common law countries given the role that ‘best interests’ has in these jurisdictions in providing treatment to patients lacking decision-making capacity. Not-for-CPR orders provide an important and transparent mechanism for making advanced decisions regarding resuscitation. However, advanced planning is not always possible and it is legally inappropriate to require CPR to be performed when it is not in the patient's best interests. Notwithstanding the difficult practical ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660336 Mon, 31 Oct 2011 04:00:00 +0100 5660336 http://www.medworm.com/index.php?rid=5660359&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006022%2Fabstract%3Frss%3Dyes Drs. Sloth and Blaivas state: “A small inexpensive TEE probe capable of sensing, pacing and defibrillating in an ideal location just behind the heart could be used in multiple care settings, including pre-hospital ones…this would result in significant improvement in the management of cardiopulmonary resuscitation in a variety of settings.” We agree with this suggestion and wish to point out that such a TEE probe with the capability of delivering a cardioverting or defibrillating shock has already been designed and initial clinical experience with patients undergoing cardioversion of atrial fibrillation has been gained . In addition, we have suggested that a sheath could be designed containing the necessary connecting wires and electrodes into which any TEE probe could be inserted, th... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660359 Mon, 24 Oct 2011 04:00:00 +0100 5660359 http://www.medworm.com/index.php?rid=5660334&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005788%2Fabstract%3Frss%3Dyes Conclusion: ED staff need to be aware that the use of ice-cold fluids is an inexpensive, readily available and easy to perform method of inducing MTH in patients who suffer an out-of hospital cardiac arrest with a ventricular rhythm. We therefore suggest that ice-cold crystalloid is routinely stocked in emergency departments and, unless contraindicated, is used to induce MTH. Optimal post-resuscitation care also includes timely treatment of the cause of the OHCA and maintenance of MTH. Staff education and care bundles may help to facilitate optimal inter-departmental management of the patient. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660334 Mon, 17 Oct 2011 04:00:00 +0100 5660334 http://www.medworm.com/index.php?rid=5505720&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211006010%2Fabstract%3Frss%3Dyes In the Czech Republic, post-cardiac arrest therapeutic hypothermia is now commonly used in hospitals. Indeed, the physician-staffed emergency medical service system, and a network of percutaneous coronary intervention centres offer a high-level post-cardiac arrest care. This also now includes the pre-hospital initiation of therapeutic hypothermia. After a feasibility study and local implementation of pre-hospital cooling, we undertook a survey about pre-hospital therapeutic hypothermia use in the Czech Republic. In October 2010, all physician members of the Czech Society for Emergency and Disaster Medicine were sent a web-based questionnaire. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505720 Mon, 17 Oct 2011 04:00:00 +0100 5505720 http://www.medworm.com/index.php?rid=5505719&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005752%2Fabstract%3Frss%3Dyes During the last decade, prospective studies conducted in the Netherlands, United Kingdom, and United States have revealed that approximately 15% of cardiac arrest survivors report conscious mental activity while their hearts are stopped. This finding is quite intriguing considering that during cardiac arrest, the flow of blood to the brain is interrupted. When this happens, the brain's electrical activity (as measured with electroencephalography [EEG]) disappears after 10–20s, and the patient is deeply comatose. As a consequence, patients who have a cardiac arrest are not expected to have clear and lucid mental experiences that will be remembered. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505719 Mon, 17 Oct 2011 04:00:00 +0100 5505719 http://www.medworm.com/index.php?rid=5505712&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005806%2Fabstract%3Frss%3Dyes We thank the correspondents for their interest in our research and we read with interest their comments on the appropriateness of attempting resuscitation from traumatic cardiorespiratory arrest (TCRA) in the military prehospital environment. Our first comment would be that, as with US military doctrine, current UK military protocol is not to attempt resuscitation from cardiorespiratory arrest in the presence of “effective enemy fire” on the battlefield. The results of our study, where TCRA on the battlefield was universally fatal despite attempted resuscitation, would seem to support this approach. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505712 Mon, 17 Oct 2011 04:00:00 +0100 5505712 http://www.medworm.com/index.php?rid=5505711&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100579X%2Fabstract%3Frss%3Dyes We read with great interest the study by Tarmey et al. determining the characteristics of military traumatic cardiorespiratory arrest (TCRA), and identifying factors associated with successful resuscitation. Rates of survival from military TCRA were similar to published civilian data, with 8% of patients surviving to discharge. Location of arrest was on the ground in more than half of cases (29 of all 52 studied patients, 56%). In real-life experience, it means that cardiopulmonary resuscitation (CPR) was performed on the battlefield. We would like to point out that this practice contrasts with well-established military guidelines. The Tactical Combat Casualty Care (TCCC), a concept of pre-hospital casualty management specific to the combat and tactical environments, was developed in the m... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505711 Mon, 17 Oct 2011 04:00:00 +0100 5505711 http://www.medworm.com/index.php?rid=5660335&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005697%2Fabstract%3Frss%3Dyes Conclusions: In trials that ascertained kidney endpoints, therapeutic hypothermia prevented neither the development of AKI nor dialysis requirement, but was associated with lower mortality. Different definitions and rates of AKI, differences in mortality rates, and concerns about the optimal target cooling temperature preclude definitive conclusions. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660335 Fri, 07 Oct 2011 04:00:00 +0100 5660335 http://www.medworm.com/index.php?rid=5505708&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005685%2Fabstract%3Frss%3Dyes Abstract: Aims: Optimal care for out-of hospital cardiac arrest (OHCA) patients may depend on the underlying aetiology of OHCA. Specifically chest compression only bystander CPR may provide greater benefit among those with cardiac aetiology and chest compressions plus rescue breathing may provide greater benefit among those with non-cardiac aetiology. The aim of this study was to generate a simple predictor model to identify OHCA patients with non-cardiac aetiology in order to accurately allocate rescue breathing.Methods: We used two independent cohorts of OHCA patients from a randomized pre-hospital trial and a prospective hospital registry (total n=3086) to assess whether the characteristics of age, gender and arrest location (private versus public) could sufficiently discriminate non-ca... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505708 Fri, 07 Oct 2011 04:00:00 +0100 5505708 http://www.medworm.com/index.php?rid=5505713&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005703%2Fabstract%3Frss%3Dyes Morphine, oxygen (O2), nitrates and aspirin, have long been the preferred initial therapeutic measures for the emergency care of patients with acute coronary syndromes (ACS). The acronym ‘MONA’ has been formed as a mnemonic of these therapeutic modalities in training and everyday practice. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505713 Wed, 05 Oct 2011 04:00:00 +0100 5505713 http://www.medworm.com/index.php?rid=5401156&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005594%2Fabstract%3Frss%3Dyes I would like to thank Professor Tipton, Mr. Ramm and their colleagues for their feedback. I was commissioned to write the editorial by the journal after significant concerns were raised about the decision-making guide during the peer review process. The editorial sought to provide an alternative view to that presented in the original paper. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401156 Wed, 05 Oct 2011 04:00:00 +0100 5401156 http://www.medworm.com/index.php?rid=5660353&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005636%2Fabstract%3Frss%3Dyes We report on three survivors of primary circulatory cardiac arrests who had good neurologic outcomes (two patients with a CPC score=1 and one patient with a CPC score=2) after mild therapeutic hypothermia, despite exhibiting massive myoclonus within the first 4h after return of spontaneous circulation. The concept that early myoclonus heralds a uniformly poor prognosis may need to be reconsidered in the era of post-cardiac arrest mild therapeutic hypothermia. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660353 Mon, 03 Oct 2011 04:00:00 +0100 5660353 http://www.medworm.com/index.php?rid=5660346&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005600%2Fabstract%3Frss%3Dyes This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005.Methods: Participants (n=807) from 19 refresher courses for out-of-hospital emergency physicians answered eight multiple-choice questions (MCQ) about ALS based on the 2005 ERC guidelines. The pass score was 75% correct answers. A multivariate logistic regression analyzed differences in passing scores between those who had previously participated in an ERC-ALS provider course and those who had not. Age, gender, regularity of working as an out-of-hospital emergency physician and the self-reported number of real resuscitation efforts within the last 6months were entered as control variables.Results: Ou... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660346 Mon, 03 Oct 2011 04:00:00 +0100 5660346 http://www.medworm.com/index.php?rid=5505714&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005351%2Fabstract%3Frss%3Dyes Fischer et al. have recently published a training manikin study with the conclusion that AED feedback led to insufficient compression depth. The manikin used in this study, while an excellent tool for CPR training, is not a calibrated measurement tool. Instead, the determination of chest compression depth via accelerometer (AED feedback) is a validated measurement method with a defined accuracy of ±6.25mm. This method has been used in multiple clinical trials to determine effectiveness of chest compressions. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505714 Mon, 03 Oct 2011 04:00:00 +0100 5505714 http://www.medworm.com/index.php?rid=5505687&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005065%2Fabstract%3Frss%3Dyes (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505687 Fri, 30 Sep 2011 04:00:00 +0100 5505687 http://www.medworm.com/index.php?rid=5505718&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005387%2Fabstract%3Frss%3Dyes The 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science with Treatment Recommendations assessed the evidence supporting the use of ultrasound during cardiac arrest to identify potentially reversible causes. They found few studies that examined the impact of ultrasound on patient outcomes during cardiac arrest. The resultant treatment recommendation stated that there is insufficient evidence to support or refute routine use of ultrasound during CPR. It also suggested that future research should address its use as a targeted intervention to detect causes of arrest and guide key procedures during resuscitation. Ultrasound was not mentioned in the section dealing with post-resuscitation care. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505718 Wed, 28 Sep 2011 04:00:00 +0100 5505718 http://www.medworm.com/index.php?rid=5505709&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005417%2Fabstract%3Frss%3Dyes Conclusions: High quality CPR was not significantly reflected in cerebral oxygenation as quantified using NIRS. Even after ROSC and subsequent significant increase in cerebral oxygenation, rSO2 readings were below previously suggested threshold of cerebral ischaemia. Improving CPR technique after an episode of low quality CPR did not significantly increase rSO2. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505709 Wed, 28 Sep 2011 04:00:00 +0100 5505709 http://www.medworm.com/index.php?rid=5505695&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005399%2Fabstract%3Frss%3Dyes Conclusions: The presence of resuscitation system errors that are evident from review of the resuscitation record is associated with decreased survival from IHCA in adults. Hospitals should target the training of first responders and code team personnel to emphasize the importance of early defibrillation, early use of vasoconstrictor medication, and compliance with ACLS protocols. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505695 Wed, 28 Sep 2011 04:00:00 +0100 5505695 http://www.medworm.com/index.php?rid=5401151&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005363%2Fabstract%3Frss%3Dyes We examined whether repeated viewing of a reminder video on a mobile phone would be an effective means of maintaining CPR and AED skills in lay responders.Methods: In a single-blind case–control study, 75 male students received training in CPR and AED use. They were allocated either to the control or to the video-reminded group, who received a memory card containing a video clip about CPR and AED use for their mobile phone, which they were repeatedly encouraged to watch by SMS text message. CPR and AED skills were assessed in scenario format by examiners immediately and 3months after initial training.Results: Three months after initial training, the video-reminded group showed more accurate airway opening (P (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401151 Wed, 28 Sep 2011 04:00:00 +0100 5401151 http://www.medworm.com/index.php?rid=5401139&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005582%2Fabstract%3Frss%3Dyes In this issue of Resuscitation two more investigations utilizing mobile phones in the context of education and implementation of CPR are published. In the first study the value of a reminder video on retention of CPR skills after a basic practical training was tested, by means of repeatedly displaying CPR including AED use on a mobile phone. CPR performance improved in the video reminder group significantly. Moreover, by viewing the educational video on average of 3.8 times within the test period of three months, the self assessed willingness to perform CPR increased in the video reminder group compared to controls without repeated video education. These results are promising. However the study has some limitations. Most importantly the test groups were small, only 54 of initially included... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401139 Wed, 28 Sep 2011 04:00:00 +0100 5401139 http://www.medworm.com/index.php?rid=5401157&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005144%2Fabstract%3Frss%3Dyes We read with great interests the meta-analysis reported by Bakalos et al. comparing patient survival with advanced life support (ALS) versus basic life support (BLS) in the pre-hospital setting and would like to present our opinions on its appropriateness for non-traumatic cardiac arrest. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401157 Fri, 23 Sep 2011 04:00:00 +0100 5401157 http://www.medworm.com/index.php?rid=5401160&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005193%2Fabstract%3Frss%3Dyes We thank Prof. Xue and co-workers for their comments on our paper dealing with predisposing factors of prehospital difficult tracheal intubation by emergency physicians. They raise primarily concerns against the relatively high rate of difficult prehospital tracheal intubation (13%). They argue that three reasons could be responsible for this finding. To resolve their concerns we would like to emphasize some of the points already made in our paper, and also add some additional information. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401160 Thu, 22 Sep 2011 04:00:00 +0100 5401160 http://www.medworm.com/index.php?rid=5660345&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005260%2Fabstract%3Frss%3Dyes Conclusions: The emotional stimulus approach to BLS-training seems to impact the ability to provide adequate compression depth up to 6months after training. Furthermore, pre-course assessment helped to keep the participants involved beyond initial training. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660345 Mon, 19 Sep 2011 04:00:00 +0100 5660345 http://www.medworm.com/index.php?rid=5401142&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005284%2Fabstract%3Frss%3Dyes Conclusion: There is limited evidence supporting the survival benefit of dispatch-assisted CPR instructions. All studies comparing survival outcomes when CPR is provided with or without the assistance of dispatch-assisted CPR instructions lack the statistical power to draw significant conclusions. Since it has been demonstrated that such instructions can improve bystander CPR rates, it is reasonable to recommend they should be provided to all callers reporting a victim in cardiac arrest. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401142 Mon, 19 Sep 2011 04:00:00 +0100 5401142 http://www.medworm.com/index.php?rid=5401138&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005338%2Fabstract%3Frss%3Dyes Outcome after resuscitation for out-of-hospital cardiac arrest (OHCA) has been reported in the medical literature for many years. These isolated reports have been the basis for interesting comparative analysis from 1990 in the “Tale of 29 cities” where survival to discharge ranged from 2% to 25%, through the “Tale of 5 regions” from 1999 with survival to discharge ranging from 6% to 22% to the prospectively collected outcome data from 2006 to 2007 in the USA, where survival rates ranged from 3% to 16%. In a comprehensive review of published papers from around the world the overall survival to hospital discharge in papers that collected data after 2000, ranged from 0.8% to 13%. Differences in methodology, emergency medical services (EMS) systems and case definitions, as well as true... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401138 Mon, 19 Sep 2011 04:00:00 +0100 5401138 http://www.medworm.com/index.php?rid=5401137&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005326%2Fabstract%3Frss%3Dyes Over one million people worldwide suffer sudden cardiac arrest each year. Survival has remained disappointingly low, varying from 1 to 12% after out-of-hospital cardiac arrest. In addition, the survival rates for patients that present in asystole or pulseless electrical activity (PEA) are substantially worse that those with arrests from ventricular fibrillation (VF) or ventricular tachycardia (VT). Despite a huge annual loss of human lives, many fundamental questions in the science of cardiopulmonary resuscitation (CPR) remain unanswered. We are still practicing cardiopulmonary resuscitation based on science that was developed more than 50 years ago. In 1889, Prevost and Battelli applied alternating and direct current shocks to fibrillate dog ventricles, and discovered that a countershock ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401137 Mon, 19 Sep 2011 04:00:00 +0100 5401137 http://www.medworm.com/index.php?rid=5324363&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005272%2Fabstract%3Frss%3Dyes ‘Medical error’ accounts for up to 98000 hospital related deaths each year in the United States – that's more than the number of deaths from either breast cancer or motor vehicle collisions! Medication-related errors occur frequently with 2% of US hospital patients experiencing a preventable adverse event and an estimated $2 billion cost for hospitals every year. Children are at particular risk, with drug dosing errors being the most frequent issue; this risk is more likely during resuscitation. Unfortunately, educational interventions alone may not remedy the problem. One promising method to improve patient safety is the use of new technologies such as smartphones that provide real-time information to rescuers to ensure correct treatments are delivered in a timely manner. (Source: R... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324363 Wed, 14 Sep 2011 04:00:00 +0100 5324363 http://www.medworm.com/index.php?rid=5401143&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005223%2Fabstract%3Frss%3Dyes The objective for this paper is to introduce a framework for uniform reporting of the dispatching process for quality improvement, collecting and reporting data and exchanging information regarding OHCA. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401143 Mon, 12 Sep 2011 04:00:00 +0100 5401143 http://www.medworm.com/index.php?rid=5660343&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005168%2Fabstract%3Frss%3Dyes Abstract: Objectives: Therapeutic hypothermia improves survival and neurological outcome in patients successfully resuscitated after cardiac arrest. Accurate temperature control during cooling is essential to prevent cooling-related side effects.Methods: Prospective observational study of 12 patients assessed during therapeutic hypothermia (32–34°C) achieved by intravascular cooling following cardiac arrest. Simultaneous temperature measurements were taken using a Swan–Ganz catheter (blood temperature BLT), nasopharyngeal probe (nasopharyngeal temperature NPT) and the urinary bladder catheter (urinary bladder temperature UBT). A total of 1728 measurements (144 measurements per patient) were recorded over a 48-h period and analyzed. Blood temperature was considered as the reference mea... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660343 Fri, 09 Sep 2011 04:00:00 +0100 5660343 http://www.medworm.com/index.php?rid=5401159&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005181%2Fabstract%3Frss%3Dyes In the recent article of Breckwoldt et al. that assessed factors associated with difficult tracheal intubation in an emergency medical services (EMS) system exclusively operating with physicians, they reported a difficult endotracheal intubation rate of 13% in the prehospital patients. In our view, however, several issues of this study might have made interpretation of their results questionable. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401159 Fri, 09 Sep 2011 04:00:00 +0100 5401159 http://www.medworm.com/index.php?rid=5401140&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100520X%2Fabstract%3Frss%3Dyes Our mentor of the past two decades, a dear friend and colleague, Dr Hal Weil, died on July 29, 2011 at his Rancho Mirage, California home. This was only 2 weeks after his full time presence in his beloved office at our Institute and 3 days after he completed his National Institutes of Health (NIH) and United States patent applications for an ‘Intelligent Alarm System’. The world of critical care medicine and resuscitation medicine has lost a great leader and mentor. He will be dearly missed by all of us, and especially by those who were trained and continuously mentored by him. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401140 Fri, 09 Sep 2011 04:00:00 +0100 5401140 http://www.medworm.com/index.php?rid=5324358&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100517X%2Fabstract%3Frss%3Dyes In this edition of Resuscitation, Kellett et al. demonstrate a worrying difference between breathing and heart rates of acutely ill patients recorded by fully trained, experienced nursing staff and those measured using a piezoelectric belt and ECG monitor (BT16 acquisition system). In general, BT16-measured heart and breathing rates were higher. Nurse-recorded breathing rate measurements were clustered around rates of 18, 20 and 22breathsmin−1. Whilst nurses measured breathing rates manually, with the potential that nurse competency played a part in the accuracy of the recorded value, the lack of correlation between nurse-recorded and BT16-measured heart rates is especially concerning, as several other devices capable of providing a valid heart (or pulse) rate were immediately available ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324358 Fri, 09 Sep 2011 04:00:00 +0100 5324358 http://www.medworm.com/index.php?rid=5505691&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005156%2Fabstract%3Frss%3Dyes Abstract: Introduction: Current European Resuscitation Council (ERC) guidelines recommend intraosseous (IO) vascular access, if intravenous (IV) access is not readily available. Because central venous catheterisation (CVC) is an established alternative for in-hospital resuscitation, we compared IO access versus landmark-based CVC in adults with difficult peripheral veins.Methods: In this prospective observational study we investigated success rates on first attempt and procedure times of IO access versus central venous catheterisation (CVC) in adults (≥18 years of age) with inaccessible peripheral veins under trauma or medical resuscitation in a level I trauma centre emergency department.Results: Forty consecutive adults under resuscitation were analysed, each receiving IO access and CVC... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505691 Mon, 05 Sep 2011 04:00:00 +0100 5505691 http://www.medworm.com/index.php?rid=5401158&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005132%2Fabstract%3Frss%3Dyes It is a common misconception that large controlled trials are generally more reliable than meta-analyses. Given the fact that meta-analysis of controlled trials is the apex of the evidence based medicine pyramid, we synthesized trials reports that compared patient survival following advanced life support (ALS) versus basic life support (BLS) in the pre-hospital setting. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401158 Mon, 05 Sep 2011 04:00:00 +0100 5401158 http://www.medworm.com/index.php?rid=5324361&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005120%2Fabstract%3Frss%3Dyes Neonatal resuscitation is practiced according to consensus guidelines, but there are variations in practice between units. These unit practices can be classified into one of the 3 stages. In the first stage, initial cynicism is counterbalanced by a desire to use the new technology better than other units that have reported their experience. In the second stage, as outcomes improve, the practice becomes integrated into the unit's culture as standard accepted care, but staff are prepared to try other methods. The third stage is the most dangerous when staff become convinced that their practice is the best and refuse to accept or consider any contradictory data. The lack of evidence for existing resuscitation practices have persuaded clinicians in many practices to move from stage 3 to 2, whi... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324361 Mon, 05 Sep 2011 04:00:00 +0100 5324361 http://www.medworm.com/index.php?rid=5505717&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005090%2Fabstract%3Frss%3Dyes We reported that capnography is the most reliable method to confirm tracheal tube placement in prehospital emergencies, with 100% sensitivity and specificity in arrest and non-arrest patients. In our opinion, end-tidal carbon dioxide levels should be monitored during CPR because they are of prognostic value for determining the outcome of resuscitative efforts and when to cease CPR in the field. In our recent pilot study, we showed that the combination of capnography and focused echocardiography (FE) with modified treatment improved survival in pulseless electrical activity (PEA) out-of-hospital cardiac arrest (OHCA). Preliminary results in our prospective study confirm that the combination of ultrasound examination and continuous capnography can improve identification of oesophageal and en... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505717 Fri, 02 Sep 2011 04:00:00 +0100 5505717 http://www.medworm.com/index.php?rid=5505715&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005119%2Fabstract%3Frss%3Dyes We report here the results of the prototype testing of the previously described Mini-VREM project. In brief we used the Kinect© sensor system to monitor the performance of CPR on a manikin. Kinect© is a motion sensing input device made by Microsoft for the Xbox 360 game console. It enables users to control and interact with the Xbox 360. It does this through a natural user interface which recognises gestures and spoken commands without the need to touch a game controller. Kinect's camera is driven by both hardware and software. It does two things: it generates a three-dimensional image of the objects in its field of view and recognises human beings among those objects. The camera transmits invisible near-infrared light and works like sonar. At this point, both the Kinect's hardware—its... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505715 Fri, 02 Sep 2011 04:00:00 +0100 5505715 http://www.medworm.com/index.php?rid=5324364&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005107%2Fabstract%3Frss%3Dyes During cardiopulmonary resuscitation (CPR), the importance of the duration of pauses has not been sufficiently recognized for many years. During this time recommendations for chest compression rates have varied between 60 and 100min−1; accordingly, pause duration between individual chest compressions has also varied. The impact on outcome of pauses for ECG rhythm analysis and tracheal intubation has been poorly understood for a long time. In the last ten years, efforts have been made to reduce pauses in chest compressions, partly because animal studies have shown that the coronary perfusion pressure drops rapidly, even during 10s breaks for ECG analysis. In contrast to these animal studies, Hoppu et al. observed in five CPR attempts in Helsinki, Finland a statistically significant increa... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324364 Fri, 02 Sep 2011 04:00:00 +0100 5324364 http://www.medworm.com/index.php?rid=5660348&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005089%2Fabstract%3Frss%3Dyes Abstract: Aim: Therapeutic hypothermia (TH) is widely used as a cardioprotective treatment for cardiac arrest. TH at 30–32°C during ischaemia and reperfusion has a cardioprotective effect. The aims of the study were to examine whether TH at 34°C with late induction (immediately after the start of reperfusion) has a cardioprotective effect and to determine if this effect is mediated by nitric oxide (NO) and phosphatidylinositol 3′-kinase (PI3K).Methods: Langendorff perfusion of Sprague–Dawley rat hearts was initiated at 75mmHg at 37°C. Left ventricle infarct sizes were evaluated by triphenyltetrazolium chloride staining after Langendorff perfusion in 6 groups (each n=7): control group; ischaemia group, with 34°C TH during ischaemia for 30min and reperfusion for 180min; reperfusion... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660348 Mon, 29 Aug 2011 04:00:00 +0100 5660348 http://www.medworm.com/index.php?rid=5505716&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005077%2Fabstract%3Frss%3Dyes This study aimed to evaluate the cardiopulmonary resuscitation (CPR) practices of French Red Cross volunteers/non-professional EMTs. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505716 Mon, 29 Aug 2011 04:00:00 +0100 5505716 http://www.medworm.com/index.php?rid=5401164&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004795%2Fabstract%3Frss%3Dyes Several external CPR techniques and devices have been developed to improve survival following cardiac arrest. Recently, a new external cardiopulmonary resuscitation device has been developed combining thoracic, abdominal and thigh compressions. Theoretical and experimental arguments support this concept, but the question here is to identify the requirements necessary for its widespread use in pre-hospital settings. We believe three things are necessary for such an implementation: (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401164 Mon, 29 Aug 2011 04:00:00 +0100 5401164 http://www.medworm.com/index.php?rid=5505703&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005016%2Fabstract%3Frss%3Dyes Conclusions: IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505703 Fri, 26 Aug 2011 04:00:00 +0100 5505703 http://www.medworm.com/index.php?rid=5401165&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005053%2Fabstract%3Frss%3Dyes Potassium has an important role in stabilizing cell membranes. Hyperkalaemia and hypokalaemia can cause life-threatening ventricular arrhythmias and even cardiac arrest. Accurate and rapid bedside identification of potassium disorders is therefore crucial. Measurement of arterial blood gases (ABGs) with electrolytes with point-of-care-testing (POCT) enables rapid potassium measurement. A small number of studies exist regarding the usefulness and reliability of electrolytes from POCT blood gas analyzers in the critical care setting. These studies show small differences between mean electrolyte values measured by POCT and central laboratory (CL) testing, but the limits of agreement are variable. In a study of patients receiving cardiopulmonary resuscitation (CPR), the limits of agreements be... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401165 Fri, 26 Aug 2011 04:00:00 +0100 5401165 http://www.medworm.com/index.php?rid=5324362&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211005041%2Fabstract%3Frss%3Dyes Interest in patient safety and human error in medicine over the last 15 years was initiated through a growing realisation that healthcare does not always deliver the care that was intended. Initially the focus on was understanding what had gone wrong by looking at events after the fact, which can provide a window now only into what can go wrong, but also how and why the system works at all. However, responding only when injury occurs has two major drawbacks. The first is that it is deeply undesirable to have to learn lessons after a tragedy. The second is that all such examinations are prone to hindsight bias, which makes it difficult to work out exactly why the erroneous chain of decisions seemed perfectly rational and appropriate at the time. It is becoming more important to look beyond ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324362 Fri, 26 Aug 2011 04:00:00 +0100 5324362 http://www.medworm.com/index.php?rid=5324360&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004990%2Fabstract%3Frss%3Dyes In 2002, when our colleagues in Europe and Australia ushered in the modern era of therapeutic hypothermia, they reported the most significant advancement in the field of resuscitation since CPR and electrical defibrillation. The subsequent adoption of contemporary post-resuscitation care has triggered a rapid escalation in the technology, resources, and expertise brought to bear upon a population whose survival was abysmal even a decade ago. While celebrating recent success, our research community now struggles to address a number of critical questions left unanswered, the most fundamental of which being, “for whom is this therapy indicated?” (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324360 Fri, 26 Aug 2011 04:00:00 +0100 5324360 http://www.medworm.com/index.php?rid=5505688&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004564%2Fabstract%3Frss%3Dyes Conclusions: Only a few studies compared the performance of different types of IO infusion devices, most of them have a low level of evidence. These studies suggested a superiority of the battery-powered IO driver over manual needles, and other semi-automatic IO infuson devices. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505688 Thu, 25 Aug 2011 04:00:00 +0100 5505688 http://www.medworm.com/index.php?rid=5660361&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004710%2Fabstract%3Frss%3Dyes The authors regret that Table 1 was reproduced twice as both Tables 1 and 2 in the above article. The authors would like to apologise for any inconvenience caused. The correct appears below. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660361 Wed, 24 Aug 2011 04:00:00 +0100 5660361 http://www.medworm.com/index.php?rid=5660351&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004801%2Fabstract%3Frss%3Dyes Abstract: Introduction: The neuroprotective ketone β-hydroxybutyrate (BHB) and the antioxidant melatonin have been found at elevated levels in hibernating mammals. Previous studies in rat models of hemorrhagic shock have suggested a benefit. We compared infusion of 4M BHB and 43mM melatonin (BHB/M) to 4M sodium chloride and 20% DMSO (control solution) to evaluate for potential benefits in porcine hemorrhagic shock.Methods: Hemorrhagic shock was induced to obtain systolic blood pressures (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660351 Mon, 22 Aug 2011 04:00:00 +0100 5660351 http://www.medworm.com/index.php?rid=5660344&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004783%2Fabstract%3Frss%3Dyes In conclusion, the plasma cell-free DNA level increases during the early post-cardiac arrest phase and can be an early prognostic factor for OHCA patients. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660344 Mon, 22 Aug 2011 04:00:00 +0100 5660344 http://www.medworm.com/index.php?rid=5660342&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004825%2Fabstract%3Frss%3Dyes Conclusion: Therapeutic hypothermia is associated with favorable neurologic outcome and survival in patients resuscitated after cardiac arrest due to non-shockable rhythms. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660342 Mon, 22 Aug 2011 04:00:00 +0100 5660342 http://www.medworm.com/index.php?rid=5505702&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004813%2Fabstract%3Frss%3Dyes Abstract: Objective: The aim of the study is to compare the accuracy of manually delivered target tidal volumes (TVs) with the conventional paediatric self-inflating bags (CPBs) versus the novel paediatric self-inflating bags (NPBs) during simulated advanced paediatric resuscitation.Methods: Before the trial begun, four target TV ranges were established using the Broselow™ Tape as a reference: 36–70ml for 6–10kg, 60–105ml for 10–15kg, 90–168ml for 15–24kg and 144–210ml for 24–30kg. An NPB with four surface marks matching the target TV ranges was prepared. Senior medical students (N=73) were enrolled. After 1 week of training in TV delivery with both CPB and NPB, subjects participated in a test simulation. Using the CPB and NPB in a random cross-over design, participants d... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505702 Mon, 22 Aug 2011 04:00:00 +0100 5505702 http://www.medworm.com/index.php?rid=5324359&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100476X%2Fabstract%3Frss%3Dyes Not news to readers of Resuscitation, out of hospital cardiopulmonary resuscitation (CPR) has dismal survival rates, ranging from 6.7% to 8.4%. Worse yet, despite the institution of tiered emergency response medical systems and CPR training of the public, this rate has not changed markedly in 30 years. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324359 Mon, 22 Aug 2011 04:00:00 +0100 5324359 http://www.medworm.com/index.php?rid=5660352&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004734%2Fabstract%3Frss%3Dyes We examined whether ventilation at high, yet clinically plausible, tidal volumes could also be detrimental, and further examined effects on end-tidal pCO2 (PETCO2).Methods: Sixteen domestic pigs were randomized to one of four ventilatory patterns representing two levels of respiratory rate (min−1) and two levels of tidal volume (ml/kg); i.e., 10/6, 10/18, 33/6, and 33/18 during chest compression after 8min of untreated VF.Results: Data (mmHg, mean±SD) are presented in the order listed above. Ventilation at 33/18 prompted higher airway pressures (p (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660352 Fri, 19 Aug 2011 04:00:00 +0100 5660352 http://www.medworm.com/index.php?rid=5660341&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004758%2Fabstract%3Frss%3Dyes Conclusion: We demonstrated that the systemic levels of MMP-7, -8 and -9 but not TIMP-1 are elevated in cardiac arrest patients in the 48h post-resuscitation period relative to the healthy controls. Patients who received therapeutic hypothermia had lower MMP-9 levels compared to non-hypothermia treated patients, which generates hypothesis about attenuation of inflammatory response by hypothermia treatment. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660341 Fri, 19 Aug 2011 04:00:00 +0100 5660341 http://www.medworm.com/index.php?rid=5401162&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004746%2Fabstract%3Frss%3Dyes We report the successful use of therapeutic hypothermia in a 69-year-old man post biventricular ICD and destination Heart Mate II LVAD placement that became unresponsive and collapsed to the floor while replacing the power source to his LVAD. Emergency medical services were called and upon arrival the patient was found unresponsive, and pulseless. An automated external defibrillator (AED) detected ventricular fibrillation (VF) and a single biphasic 200J shock restored sinus rhythm. It was determined that he was unconscious for a period of 15min. He was intubated and on arrival was found to have intact brain stem reflexes and a GCS of 6. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401162 Fri, 19 Aug 2011 04:00:00 +0100 5401162 http://www.medworm.com/index.php?rid=5401146&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004722%2Fabstract%3Frss%3Dyes Abstract: Aim: In a two-parted study, evaluate a new concept were mobile phone technology is used to dispatch lay responders to nearby out-of-hospital cardiac arrests (OHCAs).Methods: Mobile phone positioning systems (MPS) can geographically locate selected mobile phone users at any given moment. A mobile phone service using MPS was developed and named Mobile Life Saver (MLS). Simulation study: 25 volunteers named mobile responders (MRs) were connected to MLS. Ambulance time intervals from 22 consecutive OHCAs in 2005 were used as controls. The MRs randomly moved in Stockholm city centre and were dispatched to simulated OHCAs (identical to controls) if they were within a 350m distance. Real life study: during 25 weeks 1271–1801 MRs trained in CPR were connected to MLS. MLS was activated ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401146 Fri, 19 Aug 2011 04:00:00 +0100 5401146 http://www.medworm.com/index.php?rid=5505701&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004709%2Fabstract%3Frss%3Dyes Abstract: Aim: The study aims to compare the performances (ease of insertion, time to establish effective ventilation and maximal inflation pressure) of classic™ (cLMA), ProSeal™ (PLMA) and Supreme™ (SLMA) Laryngeal Mask Airway when used in a neonatal airway management manikin by inexperienced delivery room trainees. The quality of the three devices, as perceived by participants, was also evaluated.Methods: Health-care professional trainees were given a brief supervised training with the three devices. Every trainee was then observed positioning each of the three different LMAs in a single occasion. Success rate, time (IT) and maximal inflation pressure (PImax) were recorded by a single unblinded observer. A 4-point scale was used to rate participants’ perceived quality.Results: A ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505701 Fri, 12 Aug 2011 04:00:00 +0100 5505701 http://www.medworm.com/index.php?rid=5505689&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004667%2Fabstract%3Frss%3Dyes Abstract: Ethical guidelines on out-of-hospital cardio-pulmonary resuscitation (CPR) are designed to provide substantial guidance for the people who have to make decisions and deal with situations in the real world. The crucial question is whether it is possible to formulate practical guidelines that will make things somewhat easier for ambulance personnel. The aims of this article are to address the ethical aspects related to out-of-hospital CPR, primarily to decisions on not starting or terminating resuscitation attempts, using the views and experience of ambulance personnel as a starting point, and to summarise the key points in a practice guideline on the subject. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505689 Fri, 12 Aug 2011 04:00:00 +0100 5505689 http://www.medworm.com/index.php?rid=5660340&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004692%2Fabstract%3Frss%3Dyes Abstract: Background: The benefit of therapeutic hypothermia (TH) for comatose adult patients with return of spontaneous circulation after cardiac arrest (CA) with non-shockable initial rhythms is uncertain. We evaluated whether TH reduces mortality and improves neurological outcome in comatose adults resuscitated from non-shockable CA.Methods: We searched PubMed, EMBASE, CENTRAL, and BIOSIS through March 2010, to identify studies using TH after non-shockable CA. Randomized and non-randomized studies (RS and NRS) comparing survival or neurological outcome in TH and standard care or normothermia were selected. We corresponded with authors to clarify data missing from published articles. Individual and pooled statistics were calculated as risk ratios (RRs) with 95% confidence interval (CI). ... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660340 Wed, 10 Aug 2011 04:00:00 +0100 5660340 http://www.medworm.com/index.php?rid=5505707&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004680%2Fabstract%3Frss%3Dyes Conclusion: Mechanical chest compression may be a suitable therapeutic bridge to the installation of ECMO and does not interfere with ECMO catheter placement. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505707 Wed, 10 Aug 2011 04:00:00 +0100 5505707 http://www.medworm.com/index.php?rid=5660349&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004679%2Fabstract%3Frss%3Dyes Abstract: Objectives: Acute lung injury (ALI) can develop during the course of many clinical conditions, and is associated with significant morbidity and mortality. Valproic acid (VPA), a well-known anti-epileptic drug, has been shown to have anti-oxidant and anti-inflammatory effects in various ischemia/reperfusion (I/R) models. The purpose of this study was to investigate whether VPA could affect survival and development of ALI in a rat model of intestinal I/R.Methods: Two experiments were performed. Experiment I: Male Sprague-Dawley rats (250–300g) were subjected to intestinal ischemia (1h) and reperfusion (3h). They were randomized into 2 groups (n=7 per group) 30min after ischemia: Vehicle (Veh) and VPA (300mg/kg, IV). Primary end-point for this study was survival over 4h from the s... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660349 Mon, 08 Aug 2011 04:00:00 +0100 5660349 http://www.medworm.com/index.php?rid=5401166&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004643%2Fabstract%3Frss%3Dyes The Publisher regrets an issue reference within this article was not updated prior to publication; the correct information is as follows: Sweden probably has the most comprehensive system,1 but an attempt is now being made to set up a common European registry under the aegis of the European Resuscitation Council. It has the acronym EuReCa. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401166 Mon, 08 Aug 2011 04:00:00 +0100 5401166 http://www.medworm.com/index.php?rid=5238496&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004655%2Fabstract%3Frss%3Dyes In all medical interventions complications are studied intensively so that the risk–benefit can be quantified. In cardiopulmonary resuscitation (CPR), and especially in chest compression studies, side effects seem to be of little interest, yet CPR is not a harmless medical treatment. There are only a few studies on the incidence and the ideal method to detect CPR-related rib and/or sternal injuries both in survivors and in the deceased. Some authors have performed experimental CPR studies on the recently deceased. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238496 Thu, 04 Aug 2011 04:00:00 +0100 5238496 http://www.medworm.com/index.php?rid=5660350&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004618%2Fabstract%3Frss%3Dyes Conclusion: The results indicated that intraperitoneal administration of PG may have neuroprotective effects in a model of moderate, but not severe, forebrain ischemia in rats. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660350 Mon, 01 Aug 2011 04:00:00 +0100 5660350 http://www.medworm.com/index.php?rid=5660347&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004606%2Fabstract%3Frss%3Dyes Conclusion: Both quinpirole and 8-OH-DPAT led to faster induction of hypothermia. However, the outcome was not different from spontaneous hypothermia, probably because the total ‘dose’ of hypothermia was not influenced. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5660347 Mon, 01 Aug 2011 04:00:00 +0100 5660347 http://www.medworm.com/index.php?rid=5401163&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100462X%2Fabstract%3Frss%3Dyes We would like to bring to the attention of your readers a recent survey of the 1040 members of the Association of Paediatric Anaesthetists of Great Britain and Ireland. We were interested in knowing their practice in relation to the APLS and EPLS manual advice, which state that, in small children, oropharyngeal airways (OPAs) should be directly inserted, convex side up and without rotation, using a tongue depressor or laryngoscope blade. This expert group of anaesthetists were asked whether they followed this approach. There were 279 respondents – 87.5% of whom were consultants and 80.7% had over 5 years of experience in paediatric anaesthesia. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401163 Mon, 01 Aug 2011 04:00:00 +0100 5401163 http://www.medworm.com/index.php?rid=5238494&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004631%2Fabstract%3Frss%3Dyes Around the world, survival from out-of-hospital cardiac arrest is the exception rather than the rule. Despite the development of sophisticated emergency medical services (EMS), survival to hospital discharge has changed little over more than 30 years. As Sir William Thomson Kelvin pointed out, “If you cannot measure it, you cannot improve it.” Only a minority of EMS system leaders know the survival rate to hospital discharge for victims of out-of-hospital cardiac arrest cared for by their EMS professionals. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238494 Mon, 01 Aug 2011 04:00:00 +0100 5238494 http://www.medworm.com/index.php?rid=5505698&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004540%2Fabstract%3Frss%3Dyes Conclusions: Emergency research was perceived positively by cardiac arrest victims and their spouses previously involved in a resuscitation trial. Possible own participation in an emergency trial without personal consent was considered acceptable. Patients and their spouses would prefer additional research information after enrolment. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505698 Thu, 28 Jul 2011 04:00:00 +0100 5505698 http://www.medworm.com/index.php?rid=5505710&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004576%2Fabstract%3Frss%3Dyes A helicopter emergency team located a 48-year old male polytraumatised backcountry skier 10h after having fallen down approximately 100m over steep terrain lying on avalanche debris. On-site, the Glasgow Coma Scale (GCS) score was 3, the respiratory rate was 24min−1 and core body temperature 20.0°C, measured epitympanically. The patient's trachea was intubated and he was transported to our Level 1 hospital by helicopter. After take-off, ventricular fibrillation (VF) developed and continuous cardiopulmonary resuscitation (CPR) was initiated. In the emergency room the patient was monitored with near–infrared spectroscopy (NIRS; INVOS™ System, Somanetics Inc., Troy, MI), using a single probe on the right forehead. Additionally, he was monitored with ECG, invasive blood pressure measure... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505710 Wed, 27 Jul 2011 04:00:00 +0100 5505710 http://www.medworm.com/index.php?rid=5401161&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004552%2Fabstract%3Frss%3Dyes Mortality rates due to cardiac arrest following massive pulmonary embolism (PE) can range from 65 to 95%. Thrombolysis is the accepted first line treatment in cases of massive PE although it is contraindicated in patients who have suffered from recent hemorrhage or have undergone neurosurgery. Otherwise the incidence of deep venous thrombosis in patients who undergo neurosurgery varies from 18 to 50% with an incidence of subsequent pulmonary embolism which can reach up to 25%. We recently experienced the dramatic scenario of a massive PE complicated by cardiac arrest in the setting of a recent aneurismal clipping. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401161 Wed, 27 Jul 2011 04:00:00 +0100 5401161 http://www.medworm.com/index.php?rid=5324383&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100459X%2Fabstract%3Frss%3Dyes As one of the editors for the 2005 Consensus on Cardiopulmonary Resuscitation (CPR) Science with Treatment Recommendations (2005 CoSTR) and both the 2005 and the 2010 European Resuscitation Council Guidelines, I am happy to clarify the status of the impedance threshold device (ITD) in all of these documents. I will not go over all the science because this is well summarised in all of these documents as well as the 2010 CoSTR. None of these documents makes a recommendation on the use of the ITD. The Class IIa recommendation referred to by Ioannis et al. appears in the 2005 American Heart Association Guidelines: “Although increased long-term survival rates have not been documented, when the ITD is used by trained personnel as an adjunct to CPR in intubated adult cardiac arrest patients, it... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324383 Wed, 27 Jul 2011 04:00:00 +0100 5324383 http://www.medworm.com/index.php?rid=5324382&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004588%2Fabstract%3Frss%3Dyes We have read with the greatest interest the 2010 European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) which incorporate the results of systematic reviews of a wide range of topics relating to CPR. In the CPR techniques and devices section, it is stated that routine use of the impedance threshold device (ITD) in cardiac arrest is not recommended. We were quite surprised by this recommendation, as ITD had been assigned a class IIa recommendation in the 2005 ILCOR resuscitation guidelines, when traditionally used CPR drugs such as adrenaline and amiodarone were assigned a class IIb recommendation. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324382 Wed, 27 Jul 2011 04:00:00 +0100 5324382 http://www.medworm.com/index.php?rid=5324375&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003820%2Fabstract%3Frss%3Dyes This article is a report of a study which developed and tested the validity and reliability of the RAPIDS-Tool to measure student nurses’ simulation performance in assessing, managing and reporting of clinical deterioration.Background: The importance for nurses to recognize and respond to deteriorating patients has led educators to advocate for increasing use of simulation for developing this competency. However, there is a lack of evaluation tools to objectively evaluate nurses’ simulation performance on clinical deterioration.Method: The study was conducted in three phases. Phase 1 began with development of items for the RAPIDS-Tool from the basis of a literature review and a panel of national experts’ consensus. Phase 2 established the content validity of the RAPIDS-Tool by a pane... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324375 Wed, 27 Jul 2011 04:00:00 +0100 5324375 http://www.medworm.com/index.php?rid=5505699&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004539%2Fabstract%3Frss%3Dyes Conclusions: Our study has shown that in a Chinese population with a wide range of critical illness (but little trauma or intoxication), reduced GCS is significantly related to gag and cough reflexes. However, a considerable proportion of patients with a GCS≤8 have intact airway reflexes and may be capable of maintaining their own airway, whilst many patients with a GCS>8 have impaired airway reflexes and may be at risk of aspiration. This has important implications for airway management decisions. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505699 Mon, 25 Jul 2011 04:00:00 +0100 5505699 http://www.medworm.com/index.php?rid=5505696&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004527%2Fabstract%3Frss%3Dyes Conclusion: Telemetry and analysis of the TTI trace following OHCA allows objective evaluation of the quality of pre-hospital resuscitation. Targeted resuscitation training and ambulance feedback improves the quality of pre-hospital resuscitation. Further studies are required to establish possible survival benefit from this technique. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505696 Mon, 25 Jul 2011 04:00:00 +0100 5505696 http://www.medworm.com/index.php?rid=5505690&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004515%2Fabstract%3Frss%3Dyes Abstract: Background: Prior meta-analyses-reported results of randomised controlled trials (RCTs) published between 1997 and 2004 failed to show any vasopressin-related benefit in cardiac arrest. Based on new RCT-data and a hypothesis of a potentially increased vasoconstricting efficacy of vasopressin, we sought to determine whether the cumulative, current evidence supports or refutes an overall and/or selective benefit for vasopressin regarding sustained restoration of spontaneous circulation (ROSC), long-term survival, and neurological outcome.Methods: Two reviewers independently searched PubMed, EMBASE, and Cochrane Database for RCTs assigning adults with cardiac arrest to treatment with a vasopressin-containing regimen (vasopressin-group) vs adrenaline (epinephrine) alone (control-grou... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505690 Mon, 25 Jul 2011 04:00:00 +0100 5505690 http://www.medworm.com/index.php?rid=5324373&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004503%2Fabstract%3Frss%3Dyes Abstract: Objective: To compare the use of a drugs calculator on a smartphone with use of the British National Formulary for Children (BNFC) for accuracy, speed and confidence of prescribing in a simulated paediatric emergency.Design: 28 doctors and 7 medical students in a paediatric department of a District General Hospital, were asked to prescribe both a dopamine infusion and an adrenaline infusion for a hypotensive child. For one calculation they used the BNFC as their reference source and for the other they used the ‘PICU Calculator’ on the iPhone.Results: The drugs calculator on the smartphone was more accurate than the BNFC, with 28.6% of participants being able to correctly prescribe an inotropic infusion using the BNFC and 100% of participants being able to do so using the drug... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324373 Mon, 25 Jul 2011 04:00:00 +0100 5324373 http://www.medworm.com/index.php?rid=5324365&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004497%2Fabstract%3Frss%3Dyes Conclusion: There is a poor correlation between breathing and heart rates measured by traditional methods and those obtained by the BT16 device. BT16 derived breathing and heart rates, but not those measured manually, were independent predictors of in-hospital mortality. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324365 Mon, 25 Jul 2011 04:00:00 +0100 5324365 http://www.medworm.com/index.php?rid=5238505&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003765%2Fabstract%3Frss%3Dyes Abstract: Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was ‘presumed cardiac’.Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16–39 years were identified using the Victorian Ambulance Cardiac Arrest Registry (VACAR) and available coronial findings reviewed.Results: We identified 841 young adult OHCAs where the Utstein aetiology was ‘presumed cardiac’. Of these 740 died and 572 (77%) OHCAs were matched to coroner's findings. On review of the coroner's cause of death, 230 (40.2%) had a ‘confirmed cardiac’ aetiology, 221 (38.6%) were proven ‘non-cardiac’, 97 (17%) were inconclusive and 24 (4.2%) cases remained ‘open’.‘Confirmed cardiac’ causes of OHCA were ischemic hea... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238505 Mon, 25 Jul 2011 04:00:00 +0100 5238505 http://www.medworm.com/index.php?rid=5238498&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003868%2Fabstract%3Frss%3Dyes Conclusion: The use of Protocol C has been associated with rates of sustained ROSC to hospital and of survival to discharge that have reached the range of international best practice. The improvement noted in this observational study cannot be ascribed to the new protocol alone; any wider use should await randomized trials to test the impact of this single variable. Meanwhile, wider adoption of the Utstein system to compare results for treatment of OHCA will provide a potent stimulus for emergency services to seek ways of improving outcome. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238498 Fri, 22 Jul 2011 04:00:00 +0100 5238498 http://www.medworm.com/index.php?rid=5238503&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003340%2Fabstract%3Frss%3Dyes We examined 244 consecutive OHCA patients transferred to our emergency department. Head computed tomography was performed on all patients and revealed the existence of SAH in 14 patients (5.9%, 10 females). Among these, sudden collapse was witnessed in 7 patients (50%). On their initial cardiac rhythm, all 14 patients showed asystole or pulseless electrical activity, but no ventricular fibrillation (VF). Return of spontaneous circulation (ROSC) was obtained in 10 of the 14 patients (14.9% of all ROSC patients) although all resuscitated patients died later. The ROSC rate in patients with SAH (71%) was significantly higher than that of patients with either other types of intracranial haemorrhage (25%, n=2/8) or presumed cardiovascular aetiologies (22%, n=23/101) (p (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238503 Thu, 21 Jul 2011 04:00:00 +0100 5238503 http://www.medworm.com/index.php?rid=5505700&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004266%2Fabstract%3Frss%3Dyes Conclusions: Participants in a program for neonatal resuscitation in resource-limited settings demonstrated high satisfaction, high self-efficacy and gains in knowledge and skills. Mastery of ventilation skills and integration of skills into case management may not be achievable in the classroom setting without additional practice, continued learning, and active mentoring in the workplace. These findings were used to revise program structure, materials and assessment tools. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505700 Mon, 18 Jul 2011 04:00:00 +0100 5505700 http://www.medworm.com/index.php?rid=5324379&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003790%2Fabstract%3Frss%3Dyes Conclusions: Contrary to the previous animal studies, this preliminary study in humans demonstrates that blood pressures achieved before the rhythm analysis pause do not necessarily decrease after the pause but may even increase if the duration of the pause is under ten seconds and the quality of CPR is good both before and after the pause. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324379 Mon, 18 Jul 2011 04:00:00 +0100 5324379 http://www.medworm.com/index.php?rid=5238517&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100356X%2Fabstract%3Frss%3Dyes The authors would like to thank Flohe et al. for the correspondence on our manuscript entitled “ATLS certified physicians in a non-trauma system setting: Is it enough?” Concerning the comment on Tables 3 and 4, the patients that were included in the registry but for which the ISS was missing (437), were not included in the tables. This represents a missing data rate of 4.9% which we actually consider as a particular strength of the study, taking into consideration the size of the registry. In conformity, five deaths are missing from tables 3 and 4 (186 deaths registered and 181 deaths in the tables), i.e. for 5 dead patients either the ISS or the ATLS certification status of the physician, or both, were missing. However, the reported difference in outcome could not be possibly affecte... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238517 Mon, 18 Jul 2011 04:00:00 +0100 5238517 http://www.medworm.com/index.php?rid=5505706&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100428X%2Fabstract%3Frss%3Dyes Conclusions: PATD and FATD measurements showed similar responses to hypovolemic shock and volume expansion. Bioreactance persistently underestimates the CI and is not significantly altered by either inducing hemorrhagic shock, or later, through volume expansion. Bioreactance is not a suitable method for monitoring the CI in pediatric hemorrhagic shock. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505706 Fri, 15 Jul 2011 04:00:00 +0100 5505706 http://www.medworm.com/index.php?rid=5505705&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004205%2Fabstract%3Frss%3Dyes Conclusion: This rat model suggests that acute respiratory failure is responsible for the mortality caused by TMA, and therefore first aid should emphasize respiratory support. Atropinization prolonged survival time in the present study that possibly bought time for further management. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505705 Fri, 15 Jul 2011 04:00:00 +0100 5505705 http://www.medworm.com/index.php?rid=5505704&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004242%2Fabstract%3Frss%3Dyes Abstract: Aim of the study: Successful resuscitation after cardiac arrest is typically associated with cerebral and myocardial ischemia/reperfusion (I/R)-injury. Recently, we have demonstrated effects of therapeutic hypothermia (HT) and postconditioning with the volatile anesthetic sevoflurane (SEV) on I/R-mediated mechanisms in the heart and brain [Meybohm et al., PLoS One, 2009; Meybohm et al., Crit Care, 2010]. As the intestine is also highly susceptible to I/R-injury, we investigated the influence of HT and SEV on intestinal I/R-mediated events induced by cardiac arrest and successful resuscitation.Methods: Effects of I/R, HT (12h, 33°C) and a combination of HT with SEV (12h, 2.0vol%) were evaluated in a pig model of cardiac arrest and successful cardiopulmonary resuscitation. Western... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505704 Fri, 15 Jul 2011 04:00:00 +0100 5505704 http://www.medworm.com/index.php?rid=5505693&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004199%2Fabstract%3Frss%3Dyes Abstract: Objectives: We aimed to describe and compare the epidemiologic features and outcomes among patients with poisoning-induced out-of-hospital cardiac arrests (POHCAs) according to causative agent groups.Methods: We identified emergency medical service (EMS)-treated POHCA patients from a nationwide OHCA registry between 2006 and 2008, which was derived from EMS run sheets and followed by hospital record review. Utstein elements were collected and hospital outcomes (survival to admission and to discharge) were measured. We compared risk factors and outcomes according to the main poisons. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from a multivariate logistic regression model for hospital outcomes.Results: The total number of non-cardiac aetiology OHC... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505693 Fri, 15 Jul 2011 04:00:00 +0100 5505693 http://www.medworm.com/index.php?rid=5401155&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004229%2Fabstract%3Frss%3Dyes Whilst not in a position to comment on the argument regarding the academic value of the research, we have both been SAR practitioners and are now responsible for the training of those in the unenviable position of commanding incidents on scene. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401155 Fri, 15 Jul 2011 04:00:00 +0100 5401155 http://www.medworm.com/index.php?rid=5401154&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004217%2Fabstract%3Frss%3Dyes Having referred to our “pseudo systematic review”, Professor Perkins outlines the methodology for conducting a systematic review of the literature. We are aware of this methodology, however when examining the literature we were simply looking for the details of the scenario associated with prolonged underwater survival. Given the small number of relevant reports, and that the data relating to circumstance are often omitted, or are impossible to assess in terms of accuracy, we took the decision to summarise all of the papers we reviewed in Table 1 (i.e. present the raw data); this goes someway further than that required of a systematic review. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401154 Fri, 15 Jul 2011 04:00:00 +0100 5401154 http://www.medworm.com/index.php?rid=5401149&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004254%2Fabstract%3Frss%3Dyes Conclusion: In this study, no differences in placement success rate or time to insertion were detected between the King LTS-D and ETI. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401149 Fri, 15 Jul 2011 04:00:00 +0100 5401149 http://www.medworm.com/index.php?rid=5401144&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004278%2Fabstract%3Frss%3Dyes Conclusions: This is the first study to demonstrate that increased CCF among non-VF OOHCA patients is associated with a trend toward increased likelihood of ROSC. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401144 Fri, 15 Jul 2011 04:00:00 +0100 5401144 http://www.medworm.com/index.php?rid=5324385&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004230%2Fabstract%3Frss%3Dyes Manikins are essential in teaching and practicing CPR. Industry has provided them in different degrees of complexity. Costs are directly proportional to sophistication and in some cases it might be a limiting factor especially among poor people. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324385 Fri, 15 Jul 2011 04:00:00 +0100 5324385 http://www.medworm.com/index.php?rid=5324369&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003844%2Fabstract%3Frss%3Dyes Abstract: Objective: To study the feasibility, efficacy and safety of using the laryngeal mask airway (LMA) in neonatal resuscitation.Methods: In total, 369 neonates (gestational age ≥34 weeks, expected birth weight ≥2.0kg) requiring positive pressure ventilation at birth were quasi-randomised to resuscitation by LMA (205 neonates) or bag-mask ventilation (164 neonates).Results: (1) Successful resuscitation rate was higher with the LMA compared with bag-mask ventilation (P (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324369 Fri, 15 Jul 2011 04:00:00 +0100 5324369 http://www.medworm.com/index.php?rid=5238516&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003558%2Fabstract%3Frss%3Dyes We read with interest the paper by Drimousis et al. who studied the impact of Advanced Trauma Life Support (ATLS®) training on trauma survival in Greece. The authors conclude that “ATLS® certified physicians achieve worse outcomes than their non-certified colleagues when managing trauma patients.” According to the published data, ATLS® training was associated with a nearly doubling of the relative risk of death (risk ratio 1.94, 95% confidence interval [CI] 1.42–2.67) when compared to non-trained physicians. The risk difference was 1.8%, translating to a number needed to harm of 56 (meaning that any 56th Greek trauma victim may die because the trauma provider on call applied ATLS® principles rather than acting according to local standards, personal experience, or whatever). (Sou... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238516 Fri, 15 Jul 2011 04:00:00 +0100 5238516 http://www.medworm.com/index.php?rid=5238495&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004291%2Fabstract%3Frss%3Dyes Rapid sequence induction (RSI) and intubation in acute-care scenarios is a challenging procedure in unfasted individuals and complications such as unrecognized esophageal intubation occur frequently. This risk is higher because of an uncontrolled environment, there may be no advanced warning of the patient's arrival, making the team unprepared, and there may be no evaluation of mouth/jaw before the intubation attempt. Although capnography is generally regarded as the gold standard for the confirmation of correct tracheal tube placement, it has some well-known major limitations. Whilst almost every operating room is equipped with capnometers, capnography is less available in the acute care tracheal tubeing, such as in emergency departments (EDs), prehospital or critical care units. Further,... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238495 Fri, 15 Jul 2011 04:00:00 +0100 5238495 http://www.medworm.com/index.php?rid=5401148&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004175%2Fabstract%3Frss%3Dyes Conclusion: In this analysis of OOHCA airway management, first attempt BLS King LT-D placement success exceeded that of first attempt paramedic ETI success. In addition, patients in the King LT-D group were more likely to have had an advanced airway attempted and to have had a successful advanced airway placed when multiple attempts were required. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401148 Wed, 13 Jul 2011 04:00:00 +0100 5401148 http://www.medworm.com/index.php?rid=5324370&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003546%2Fabstract%3Frss%3Dyes Conclusions: There has been a significant decrease in the number of opioid overdoses during this 10-year-period. Long-term mortality is high in these patients and highest in those with advanced age and numerous episodes of opioid overdose. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324370 Wed, 13 Jul 2011 04:00:00 +0100 5324370 http://www.medworm.com/index.php?rid=5238518&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004187%2Fabstract%3Frss%3Dyes We report on a medical emergency, which was handled at dusk in the forecourt of a neighbouring rehabilitation clinic. A 58-year-old male patient, who had undergone a triple CABG-operation 11 days before, collapsed and fell on his face. Primarily, he suffered from ventricular fibrillation. Despite problematic conditions for intubation (position of the patient, lighting conditions, and intraoral bleeding), an I-gel supraglottic airway (I-gel), size 4, was easily placed without having to cease thorax compression in the neutral position. Ventilation with adequate thoracic excursion was possible without any leakage of air. Following successful defibrillation, an endotracheal tube, size 7 (Rüsch Company, Kernen, Germany) was placed without difficulty to achieve complete and successful airway ma... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238518 Wed, 13 Jul 2011 04:00:00 +0100 5238518 http://www.medworm.com/index.php?rid=5238515&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003856%2Fabstract%3Frss%3Dyes In October 2010 the Resuscitation Council (UK) and the European Resuscitation Council published new guidelines for basic life support. These guidelines strongly emphasise the importance of high quality chest compressions. In particular they recommend compression of the chest by at least 5cm, with the European guideline stating that there is insufficient evidence to recommend an upper limit for chest compression. Rescuers are also now advised to place their hands in the centre of the chest rather than count up from the xiphisternum. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238515 Mon, 11 Jul 2011 04:00:00 +0100 5238515 http://www.medworm.com/index.php?rid=5110163&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003881%2Fabstract%3Frss%3Dyes The best opportunity today currently for improving long-term survival after cardiac arrest occurs during the post resuscitation period. Survival rates have increased due to efforts to expand basic life support, particularly by increasing bystander willingness to perform chest compressions, and improved EMS protocols for advanced life support, but continued improvements will most likely come from an organized and aggressive treatment approach to the recently resuscitated. Expectations of poor outcome following resuscitation are no longer justified. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110163 Sun, 10 Jul 2011 23:00:00 +0100 5110163 http://www.medworm.com/index.php?rid=5110160&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004163%2Fabstract%3Frss%3Dyes We read with great interest the works of Dr. Testori and Dr. Pfeifer in this edition of Resuscitation. Since the two landmark studies in 2002, therapeutic hypothermia (TH) created a paradigm shift in the care of out-of-hospital (OHCA) VF/VT post-cardiac arrest patients. This rhythm represents the minority of patients in many systems and there are no randomized, controlled trials to inform clinicians on the utility of TH in OHCA patients experiencing non-VF/VT arrests or in-hospital cardiac arrest. Given the robust effect of TH in the original trials, many facilities provide TH to all comatose post-cardiac arrest patients regardless of rhythm or location of arrest. This approach is justified by the fact that TH seems to improve primarily neurological recovery, and “Why would the brain car... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110160 Sun, 10 Jul 2011 23:00:00 +0100 5110160 http://www.medworm.com/index.php?rid=5110158&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003807%2Fabstract%3Frss%3Dyes In this issue of Resuscitation are two papers reporting the use of extracorporeal life support (ECLS) in the community for out of hospital cardiac arrest. Sadly, both patients had sustained irreversible cerebral anoxic injury prior to ECLS initiation and, despite cardiac recovery, they both died. Now that ECLS technology and clinical expertise has progressed to the level where community ECLS has become possible we need to direct our attention to the fundamental questions that are raised by these two case reports. Firstly how can we identify patients prospectively who have suffered irreversible cerebral anoxia, and secondly how can we engineer the resuscitation process to reduce the duration of no flow (prior to CPR) and low flow (during CPR) which occur before initiation of ECPR (ECLS)? Th... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110158 Sun, 10 Jul 2011 23:00:00 +0100 5110158 http://www.medworm.com/index.php?rid=5238523&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004138%2Fabstract%3Frss%3Dyes We would like to describe an event which we feel lends support to the National Defibrillator Programme (NDP). The event occurred on a weekday morning at a busy London Underground station, where an elderly gentleman with a history of hypertension collapsed unconscious. He was attended to by the author and two other senior hospital registrars who were on their way to work. Whilst his immediate care was attended to, paramedics, medical equipment and an automatic external defibrillator (AED) were requested from staff at the station. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238523 Fri, 08 Jul 2011 04:00:00 +0100 5238523 http://www.medworm.com/index.php?rid=5110157&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100414X%2Fabstract%3Frss%3Dyes Adrenaline (epinephrine) has kept its place in cardiac arrest guidelines despite limited evidence for or against its use. When given during cardiopulmonary resuscitation (CPR) adrenaline increases both coronary and cerebral blood flow and, once return of spontaneous circulation (ROSC) is achieved, increases myocardial contractility. On the other hand, when given during ventricular fibrillation (VF) adrenaline increases myocardial oxygen consumption and fails to improve myocardial oxygen balance. Adrenaline has also been shown to reduce cerebral microcirculatory flow during CPR. Recognition of the importance of high quality chest compressions with minimal interruption, defibrillation, and post cardiac arrest care has also led to a de-emphasis of the role of drugs during resuscitation. (Sour... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110157 Thu, 07 Jul 2011 23:00:00 +0100 5110157 http://www.medworm.com/index.php?rid=5401153&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004102%2Fabstract%3Frss%3Dyes Conclusions: In post-cardiac arrest period, visual evaluation of long-axis TEE loops allows prediction of volume responsiveness with good sensitivity and reasonable specificity even by novice users, and may therefore be suitable for implementation into treatment protocols. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401153 Thu, 07 Jul 2011 04:00:00 +0100 5401153 http://www.medworm.com/index.php?rid=5324378&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003819%2Fabstract%3Frss%3Dyes Conclusion: In the presence of severe controlled hemorrhage, P188 improved median survival time. However, retardation of blood clotting raises concerns as to its use in the presence of uncontrolled hemorrhage. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324378 Thu, 07 Jul 2011 04:00:00 +0100 5324378 http://www.medworm.com/index.php?rid=5505694&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004060%2Fabstract%3Frss%3Dyes Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505694 Wed, 06 Jul 2011 04:00:00 +0100 5505694 http://www.medworm.com/index.php?rid=5324368&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100400X%2Fabstract%3Frss%3Dyes Conclusions: Initial illness severity explains much of the variation in cardiac arrest outcome. This model provides prognostic information at hospital arrival and may be used to stratify patients in future studies. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324368 Wed, 06 Jul 2011 04:00:00 +0100 5324368 http://www.medworm.com/index.php?rid=5238519&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003832%2Fabstract%3Frss%3Dyes Cardiac arrest (CA) encompasses two distinct, pathophysiological mechanisms; the cessation of activity of the heart and respiration. This is why CA is used interchangeably with the term cardiorespiratory arrest. It was more than 50 years ago when Kouwenhoven, Safar and Jude proposed the idea of cardiopulmonary resuscitation (CPR). However, it might be time to reconsider the term. CA results in combined respiratory and metabolic acidosis, because pulmonary gas exchange ceases and cellular metabolism becomes anaerobic. During the global ischemia in CA, the intracellular environment is characterized by reduction in the myocardial oxygen tension (PO2), increase in carbon dioxide tension (PCO2) and increase of the pH. The concentrations of both O2 and CO2 affect ventilation and gas exchange. (S... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238519 Wed, 06 Jul 2011 04:00:00 +0100 5238519 http://www.medworm.com/index.php?rid=5505697&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004023%2Fabstract%3Frss%3Dyes Conclusions: Differences were observed between the EMS agencies participating in CARES. The clinical impact of these observed differences in agency and provider characteristics on OHCA outcomes deserves study. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5505697 Mon, 04 Jul 2011 04:00:00 +0100 5505697 http://www.medworm.com/index.php?rid=5401150&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004011%2Fabstract%3Frss%3Dyes Conclusions: Availability of AEDs was not independently associated with hospital survival. Shockable presenting rhythms were not common and, in keeping with the manufacturer's specifications, the AEDs did not shock all potentially shockable rhythms. The hands-off time associated with automated rhythm management was considerable. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401150 Mon, 04 Jul 2011 04:00:00 +0100 5401150 http://www.medworm.com/index.php?rid=5401147&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004047%2Fabstract%3Frss%3Dyes Abstract: Objectives: For experienced personnel endotracheal intubation (ETI) is the gold standard to secure the airway in prehospital emergency medicine. Nevertheless, substantial procedural difficulties have been reported with a significant potential to compromise patients’ outcomes. Systematic evaluation of ETI in paramedic operated emergency medical systems (EMS) and in a mixed physician/anaesthetic nurse EMS showed divergent results. In our study we systematically assessed factors associated with difficult ETI in an EMS exclusively operating with physicians.Methods: Over a 1-year period we prospectively collected data on the specific conditions of all ETIs of two physician staffed EMS vehicles. Difficult ETI was defined by more than 3 attempts or a difficult visualisation of the lar... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5401147 Mon, 04 Jul 2011 04:00:00 +0100 5401147 http://www.medworm.com/index.php?rid=5324384&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100387X%2Fabstract%3Frss%3Dyes Cardiac arrest is a significant medical emergency that can occur in outpatient medical facilities. Guidelines 2010 of the European Resuscitation Council advocate that defibrillators should be available throughout outpatient medical facilities (www.resus.org). The occurrence of cardiac arrests in dental practices is low (0.002 per dentist per year), but several studies indicate dental surgeons may have to treat a cardiac arrest and the availability of a defibrillator may be useful. The Resuscitation Council (UK) and several publications recommend that dental practices have an automated external defibrillator. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324384 Mon, 04 Jul 2011 04:00:00 +0100 5324384 http://www.medworm.com/index.php?rid=5324381&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004072%2Fabstract%3Frss%3Dyes We thank Dr Cabrini et al. for their comments. We agree that early application of NIV is desirable and important. In our hospital, typically, patients with mild/early respiratory failure already receive treatment in NIV-capable wards. However, our report focuses on the most severe presentations of acute respiratory failure, which develop in the wards and which not only trigger a MET call, but also required immediate intervention. These patients have significant physiological respiratory instability and NIV is part of a cluster of critical care interventions aimed at increasing patient safety and restoring physiological stability. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324381 Mon, 04 Jul 2011 04:00:00 +0100 5324381 http://www.medworm.com/index.php?rid=5324380&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004084%2Fabstract%3Frss%3Dyes We read we great interest the paper by Schneider et al. on non-invasive ventilation (NIV) use in medical emergency team (MET) calls. The paper offers a precious insight into real-life MET interventions for patients suffering from acute respiratory failure (ARF), showing that NIV is a common MET-delivered treatment. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324380 Mon, 04 Jul 2011 04:00:00 +0100 5324380 http://www.medworm.com/index.php?rid=5324377&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003583%2Fabstract%3Frss%3Dyes Conclusions: A mathematical model of ventilation was successfully derived allowing manipulation of multiple pulmonary physiological variables to predict MITP and potentially identify optimal ventilation strategies. This model suggests the use of lower ventilation rates and larger tidal volumes to minimize the hemodynamic effects of positive pressure ventilation in patients with hypoperfusion but normal lung characteristics. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324377 Mon, 04 Jul 2011 04:00:00 +0100 5324377 http://www.medworm.com/index.php?rid=5324374&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003534%2Fabstract%3Frss%3Dyes Conclusions: Trained nurses are able to identify a deteriorating patient and react more appropriately. However, despite rigorously implementing MEWS/SBAR methodology, these tools were rarely used. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324374 Mon, 04 Jul 2011 04:00:00 +0100 5324374 http://www.medworm.com/index.php?rid=5324371&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004035%2Fabstract%3Frss%3Dyes Conclusion: Prehospital discharge-on-scene after naloxone treatment is associated with a low risk of death due to rebound toxicity. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324371 Mon, 04 Jul 2011 04:00:00 +0100 5324371 http://www.medworm.com/index.php?rid=5324366&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004096%2Fabstract%3Frss%3Dyes Abstract: Background: Recognition of critically abnormal vital signs has been used to identify critically ill patients for activation of rapid response teams. Most studies have only analyzed vital signs obtained at the time of admission. The intent of this study was to examine the association of critical vital signs occurring at any time during the hospitalization with mortality.Methods: All vital sign measurements were obtained for hospitalizations from January 1, 2008 to June 30, 2009 at a large academic medical center.Results: There were 1.15 million individual vital sign determinations obtained in 42,430 admissions on 27,722 patients. Critical vital signs were defined as a systolic blood pressure 120bpm, temperature 38.9°C, oxygen saturation (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324366 Mon, 04 Jul 2011 04:00:00 +0100 5324366 http://www.medworm.com/index.php?rid=5238514&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS030095721100342X%2Fabstract%3Frss%3Dyes Abstract: Objectives: To evaluate the effect of age on heart rate variability (HRV) in a rat model of therapeutic hypothermia.Methods: Thirty-six male Sprague–Dawley rats (18 were 2 months old and 18 were 18 months old) were randomized into one of three groups: normothermia (37°C), mild hypothermia (34°C), and moderate hypothermia (31°C). An electrocardiogram (ECG) was recorded at baseline and continuously for 1h once the target core body temperature was reached. Various heart rate variability measurements were calculated.Results: Significant effects of age were observed in respect to the ratio of standard deviation of all normal to normal R-R [NN] intervals (SDNN)/standard deviation of the differences between adjacent NN intervals (SD of delta NN) (P=0.037), low frequency (LF) power,... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238514 Mon, 04 Jul 2011 04:00:00 +0100 5238514 http://www.medworm.com/index.php?rid=5238511&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003522%2Fabstract%3Frss%3Dyes Conclusions: The use of a mechanical compression aid was not associated with substantial differences in time to first defibrillation or no-flow time in the early phase of CPR. However, constant but poor chest compressions due to failure in recognizing and correcting a malposition of the device may counteract a potential benefit of mechanical chest compressions. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238511 Mon, 04 Jul 2011 04:00:00 +0100 5238511 http://www.medworm.com/index.php?rid=5238509&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003571%2Fabstract%3Frss%3Dyes Abstract: Introduction: Studies show that students, trained to perform compressions between 40 and 50mm deep, often do not achieve sufficient depth at retention testing. We hypothesized that training to achieve depths >50mm would decrease the proportion of students with depth 50mm. Quality of compressions was tested after 6 months.Results: The SG and DG groups consisted of 90 (67% female) and 100 (58% female) participants respectively. At the end of training, all students reached the target depth without overlap between groups. After 6 months, the proportion of students achieving a depth 50mm was 5/89 (6%) for the SG and 44/89 (49%) in the DG (P (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238509 Mon, 04 Jul 2011 04:00:00 +0100 5238509 http://www.medworm.com/index.php?rid=5238507&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003601%2Fabstract%3Frss%3Dyes Abstract: Objective: The purpose of this study was to determine the prevalence of in-hospital hypotension in patients surviving to admission after resuscitation from out-of-hospital cardiac arrest and compare it to that of traditional Utstein factors in predicting in-hospital mortality.Methods: Single-center retrospective cohort of adult patients surviving to hospital admission after resuscitation from out-of-hospital sudden death between January 1, 2006 and October 31, 2009. Study variables included Utstein template data: age, sex, initial rhythm, witnessed or nonwitnessed arrest, presence or absence of bystander CPR, location of arrest, response time (time of 9-1-1 dispatch to first vehicle arrival), and hypotension (systolic pressure (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5238507 Mon, 04 Jul 2011 04:00:00 +0100 5238507 http://www.medworm.com/index.php?rid=5110166&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211004059%2Fabstract%3Frss%3Dyes Conclusion: Patients receiving adrenaline during cardiac arrest had no statistically significant improvement in the primary outcome of survival to hospital discharge although there was a significantly improved likelihood of achieving ROSC. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110166 Sun, 03 Jul 2011 23:00:00 +0100 5110166 http://www.medworm.com/index.php?rid=5324372&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003996%2Fabstract%3Frss%3Dyes Conclusions: Unnecessary interruptions of CPR occur frequently and consume approximately one-third of the time patients should receive continuous life support. Unnecessary interruptions are mainly characterized by secondary medical activities that may be perceived as meaningful. During the majority of unnecessary interruptions, all team members focus on the same secondary activity, indicating shortcomings in task distribution in the resuscitation team. The findings emphasize the importance of team training with particular emphasis on situational awareness and task distribution. (Source: Resuscitation) Resuscitation journals http://www.medworm.com/rss/comments.php?id=5324372 Thu, 30 Jun 2011 04:00:00 +0100 5324372 http://www.medworm.com/index.php?rid=5110162&cid=s_38646_14_f&fid=38646&url=http%3A%2F%2Fwww.resuscitationjournal.com%2Farticle%2FPIIS0300957211003595%2Fabstract%3Frss%3Dyes Brain injury happens shortly after the onset of cardiac arrest and a neurologic injury cascade proceeds for days after successful resuscitation. The extent of brain injury is a major determinant of survival and quality of life for survivors of cardiac arrest. Over the years, the dire impact of brain injury and the failure of many clinical trials of neuroprotective agents have contributed to the nihilism of this condition. As a consequence, clinicians developed prognostication strategies that take into account the neurologic examination, along with some diagnostic test, to attempt to reliably identify early in the course of the injury which survivor will die or have poor functional outcome. Once a high likelihood of poor outcome is determined, a plan or recommendation to limit or cease ongo... Resuscitation journals http://www.medworm.com/rss/comments.php?id=5110162 Wed, 29 Jun 2011 23:00:00 +0100 5110162