C D Deakin

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..The place of defibrillation in the chain of survival is paramount and this review covers advances in this aspect of resuscitation over the past 18 months...

..The recent introduction of a disposable laryngeal mask airway has provided paramedics with an alternative to endotracheal intubation. Time taken to secure the airway with each device was compared in patients undergoing elective surgery...

..The effect of sequential biphasic shocks on TTI is unknown. We therefore studied patients undergoing elective cardioversion using a biphasic waveform to establish whether this is a phenomenon seen in the clinical setting...

..We therefore hypothesised that earlier sodium channel activation would result in earlier restoration of the first sinus beat following elective DC cardioversion...

..We retrospectively examined patients with ACS to identify whether this triage tool had been able to allocate an appropriate emergency response...

..11.1 telephone instructions are limited in their ability to produce correctly performed basic life support. The current telephone instructions were modified in an attempt to improve areas of poor CPR performance...

..We measured passive ventilation during optimal chest compression to determine whether compression-only CPR provides adequate gas exchange during cardiac arrest...

..The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service...

..Continuous ECG monitoring during the procedure has allowed presentation of sequential ECGs recorded during the procedure...

..The importance of past medical history and the incidence of co-morbidity in relation to pre-hospital care are discussed...

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..Does the ALS course give non-anaesthetists adequate skills to manage an airway during a cardiac arrest?..

..We evaluated a current paediatric telephone protocol (AMPDS v11.1) to assess the effectiveness of verbal CPR instructions in paediatric cardiac arrest...

..Petco2 correlates with outcome after prehospital primary cardiac arrest, but association with outcome from prehospital trauma has not been established...

..No study has yet established the optimal paddle force required to minimise TTI in children of different ages...

..This may theoretically result in a higher TTI than a longitudinal orientation because of poorer contact at the lateral paddle edges. We compared TTI with the apical paddle in both a transverse and longitudinal orientation...

..The relative contribution of each mechanism is unknown...

..This study was carried out to assess the effect of evaporative drying of defibrillation pads on TTI...

..Therefore transthoracic current during defibrillation is unlikely to be affected by different respiratory gases. This is the first study to document that these respiratory gases do not change the impedance of transthoracic pathways...

..We designed a prospective randomised double-blinded controlled study to determine the effect of biphasic or monophasic waveform on the pain and inflammation occurring after elective cardioversion...

..Little is known as to whether laypeople carrying out these instructions deliver effective CPR...

..27) and dominant hand-grip strength (r2=0.34). The ERC recommendation of 12 kg paddle force is not achievable by the majority of defibrillator operators...

..to determine whether paddle force applied during defibrillation meets the 12 kg (approximately 120 N) force recommended by the advanced life support (ALS) guidelines of the European Resuscitation Council (ERC)...

..Transfusion reactions, infection risk and cost should stimulate us to decrease this transfusion rate. We tested the efficacy of autotransfusion of washed postoperative mediastinal fluid in a prospective randomized trial...

..3 (15.8) Omega at term and 91.6 (11.8) Omega 6-8 weeks after delivery; the difference was not statistically significant. We conclude that current energy requirements for adult defibrillation are appropriate for use during pregnancy...

..46; P<0.001). CONCLUSIONS: When used in addition to intra-operative cell salvage, aprotinin is the most efficacious pharmacological therapy for reducing patient exposure to any allogeneic transfusion during first-time cardiac surgery...

..CONCLUSIONS: Defibrillation pads can be used for up to 30 min without evaporation causing a clinically significant increase in TTI. The passage of a defibrillation current across pads does not further accelerate water loss...

..To reduce burns, operators should apply optimal paddle force equally to both paddles, with the paddles applied so as to provide even contact along their edges. Burns may also be minimised by starting with lower energy shocks...

..The effectiveness of this technique was examined in a manikin-based study...

..This study assessed one technique for investigating the aspiration risk in ED patients. Cricoid pressure is used to reduce this risk and the technique may also examine this manoeuvre...

..No studies have investigated this effect on ST change with atrial arrhythmias. We studied the efficacy of the Welch Allyn-MRL PIC biphasic defibrillator...

..This study used simulated CPR with a LUCAS device to measure resulting ambient oxygen concentrations and assess safety of the device...

..9 kgf, and for children >10 kg using adult paddles is 5.1 kgf. We compared defibrillation paddle force applied during simulated paediatric defibrillation with these optimal values...

..We designed a study to determine whether the application of non-steroidal anti-inflammatory cream prior to cardioversion reduces their incidence and severity...

..We designed a prospective double-blinded controlled study to determine whether the application of steroid cream prior to cardioversion reduces their incidence and severity...

..0001). CONCLUSION: Despite the subjective difficulties of defibrillating patients in the AP position whilst leaning over them, use of manual paddles achieves a lower TTI than that achieved with self-adhesive pads...

..Although national and international safety standards caution against defibrillating under this circumstance, it appears to be an area of confusion that we have investigated in more detail...

..When the chests of nonhirsute patients were shaved, a decrease in TTI occurred, which was probably related to the creation of low-impedance pathways through skin abrasions...

..For arterial blood sampling it was used by 60% of anaesthetists and 2% of ward doctors. Previous recommendations to use local anaesthesia seem to have been ignored, and in many instances these procedures are more painful than necessary...

..We observed detailed ventilation variables prospectively during manual ventilation of 12 cardiac arrest patients treated in the emergency department of a UK Hospital...

..This review is intended to help the clinician to balance the pros and cons of fluid therapy in the individual patient...

..We evaluated a current telephone protocol (based on 2000 ILCOR guidelines) to assess the effectiveness of verbal CPR instructions...