Facts, Legends and Myths on the Evolution of Resuscitation

This study aimed to overview in chronological order a number of "facts" and "myths" that have been reported in the literature on the history of resuscitation. In particular, this review presents remarkable resuscitation attempts, innovative techniques and landmarked events that enhanced resuscitation in terms of science, history and intervention from ancient times until today. The resuscitation methods were designed for victims needing help in various locations of three-dimensional space, with emphasis on those occurring on, or brought to, land. These methods required single or double rescues to be carried out. Some of them were either empirically or scientifically designed. In some techniques, the stimuli used to revive the victim were rather painful and dangerous or at least disturbing. In some techniques, respiration was attempted with various more or less sophisticated devices. Finally, a small number of cases have been mistakenly reported by previous scholars as resuscitation attempts

Outline of the 2005 European Resuscitation Council Guidelines

Resuscitation guidelines are revised and updated about every 5 years and this happens because resuscitation science continues to advance and clinical guidelines must be updated regularly to reflect these developments and advise healthcare providers on best practice. To date, the 2000 resuscitation guidelines are followed in Malta and other countries worldwide. These guidelines have been now revised by the International Liaison Committee on Resuscitation (ILCOR) and a consensus has been reached resulting in the publication of the 2005 guidelines. The ILCOR was formed in 1993 and its mission is to identify and review international science and knowledge relevant to CPR, and to offer consensus on treatment recommendations. A total of 281 experts completed 403 worksheets on 276 topics. Three hundred and eighty specialists from 18 countries attended the 2005 International Consensus Conference on Cardiopulmonary Resuscitation (CPR) Science, which took place in Dallas in January 2005. Science statements and treatment recommendations were agreed by the conference participants and the results are now the new 2005 Resuscitation Guidelines. These ILCOR guidelines will be published internationally on the 28 th November 2005 for the first time. The Malta Resuscitation Council (MRC) participated in meetings of the European Resuscitation Council (ERC) where the dissemination of these new guidelines was discussed. This article will try to summarize the major changes incorporated in the new guidelines.peer-reviewe

Resuscitation and quantification of stressed Escherichia coli K12 NCTC8797 in water samples

The aim of this study was to investigate the impact on numbers of using different media for the enumeration of Escherichia coli subjected to stress, and to evaluate the use of different resuscitation methods on bacterial numbers. E. coli was subjected to heat stress by exposure to 55 °C for 1 h or to light-induced oxidative stress by exposure to artificial light for up to 8 h in the presence of methylene blue. In both cases, the bacterial counts on selective media were below the limits of detection whereas on non-selective media colonies were still produced. After resuscitation in non-selective media, using a multi-well MPN resuscitation method or resuscitation on membrane filters, the bacterial counts on selective media matched those on non-selective media. Heat and light stress can affect the ability of E. coli to grow on selective media essential for the enumeration as indicator bacteria. A resuscitation method is essential for the recovery of these stressed bacteria in order to avoid underestimation of indicator bacteria numbers in water. There was no difference in resuscitation efficiency using the membrane filter and multi-well MPN methods. This study emphasises the need to use a resuscitation method if the numbers of indicator bacteria in water samples are not to be underestimated. False-negative results in the analysis of drinking water or natural bathing waters could have profound health effects

Pediatric Resuscitation: Evaluation of a Clinical Curriculum

Objective: To assess the impact of a 6-hour pediatric resuscitation curriculum on the comfort levels of resident physicians’ evaluation and treatment of critically ill pediatric patients. Methods: An evaluation instrument assessed resident comfort levels, measured on a seven digit Likert scale ranging from significantly uncomfortable to significantly comfortable, in 13 areas of pediatric resuscitation. To complete the curriculum, residents had to demonstrate proficiency in knowledge and procedural skills during mock resuscitation scenarios and on both written and oral examinations. Results: Thirty-one residents participated in the study: 51.6% were pediatric, 12.9% were medicine/pediatric and 35.5% were emergency medicine residents. Participants in the curriculum had little previous experience with pediatric resuscitation (83% had been involved in five or fewer pediatric resuscitations). In all 13 areas of pediatric resuscitation tested, residents reported improvement in comfort levels following the course (p<0.002; Wilcoxon Signed Rank Tests). The most significant changes were observed for the following items: resuscitation of pulseless arrest, performance of cardioversion and defibrillation, performance of intraosseous needle insertion, and drug selection and dosing for rapid sequence intubation. Fewer than 48% of learners rated themselves as comfortable in these areas prior to training, but after completion, more than 80% rated themselves in the comfortable range. All residents but one received passing scores on their written examinations (97%). During the mock resuscitation scenarios and oral examination, 100% of the residents were assessed to have ‘completely’ met the learning objectives and critical actions Conclusion: Implementation of a pediatric resuscitation curriculum improves pediatric and emergency medicine residents’ comfort with the evaluation and treatment of critically ill pediatric patients. This curriculum can be used in residency training to document the acquisition of core competencies, knowledge and procedural skills needed for the evaluation and treatment of the critically ill child. The results reported in this study support using this model of instructional design to implement educational strategies, which will meet the requirements of graduate education

STUDI LITERATUR DAMPAK MENGHADIRKAN KELUARGA UNTUK MENYAKSIKAN DAN MENDAMPINGI PROSES RESUSITASI PADA PASIEN DI UNIT GAWAT DARURAT DAN ICU

Background: Resuscitation is a technique that is very useful for saving lives in emergencies when a heart attack occurs suddenly and the heartbeat stops. The purpose of writing this research is to find out how the literature review has on the impact of bringing the family to witness and accompany the resuscitation process for patients in the Emergency Room and ICU. Methods: This research uses the Literature Review method with literature sources using the Google Scholar, BMC, Pubmed, and Science Direct databases. Of the 14.916 articles, 10 articles were found that met the inclusion criteria such as research methods such as cohort study, qualitative, cross-sectional, RCT, full text articles published in the last 10 years (2015-2024). Study quality writing using the Joanna Briggs Institute (JBI). Data analysis uses thematic analysis. Results: There are 3 articles that explain that health workers feel disturbed by the presence of family, 8 articles explain the benefits of family presence, and 2 articles explain the success of families during resuscitation. Discussion: based on 10 articles that have been analyzed, there are different responses and opinions from family members and health professionals, namely nurses and doctors. Then the level of resuscitation success witnessed by the family during resuscitation had no effect starting from the return of spontaneous circulation to the survival rate and neurological status of the patient who survived. Including the duration of resuscitation carried out on patients who survived and those who did not survive also had no effect (between hospitals with an FPDR policy and hospitals without a policy)

Nurses\u27 Perception of Family Presence During Resuscitation

Background Family witnessed resuscitation (FWR) is the concept of allowing family members at bedside during cardiopulmonary resuscitation. Studies have shown that the lack of standard policies by hospitals regarding FWR forces nurses to make different decisions regarding family presence at bedside during resuscitation. The framework for this study is Sandman\u27s teleological model. Objectives To examine nurses\u27 perceptions of having family members present during adult cardiac resuscitation. Methods A descriptive study of 57 registered nurses (n = 57) from northern California was conducted. Participants completed a mailed survey consisting of a 22-item Likert scale questionnaire titled Family Presence Risk-Benefit Scale. Results Analysis from the questionnaire showed that the majority of participants were between the ages of 40-63 and had more than 20 years of working experience. About 51.9% worked in units with no formal policy on FWR and 71.7% had participated in a cardiac resuscitation. Study results show that nurses had varied opinions, but there were no statistically significant results to indicate that the majority of nurses favor FWR. Conclusions The study found there was no statistically significant data to conclude there was any consensus among nurses about the risks or benefits of families at bedside. This study concludes that nurses want to be present in the room if their loved ones were being resuscitated. To help nurses with decision-making guidelines during resuscitation, it is recommended that health-care institutions establish standard policies regarding FWR. Further studies need to be conducted to investigate nurses\u27 perceptions regarding FWR

2019 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations : summary from the basic life support; advanced life support; pediatric life support; neonatal life support; education, implementation, and teams; and first aid task forces

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research

Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest : The PRINCESS Randomized Clinical Trial

© 2019 American Medical Association. All rights reserved.Importance: Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups. Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. Trial Registration: ClinicalTrials.gov Identifier: NCT01400373.Peer reviewedFinal Accepted Versio

Inter-rater reliability of post-arrest cerebral performance category (CPC) scores.

PURPOSE: Cerebral Performance Category (CPC) scores are often an outcome measure for post-arrest neurologic function, collected worldwide to compare performance, evaluate therapies, and formulate recommendations. At most institutions, no formal training is offered in their determination, potentially leading to misclassification. MATERIALS AND METHODS: We identified 171 patients at 2 hospitals between 5/10/2005 and 8/31/2012 with two CPC scores at hospital discharge recorded independently - in an in-house quality improvement database and as part of a national registry. Scores were abstracted retrospectively from the same electronic medical record by two separate non-clinical researchers. These scores were compared to assess inter-rater reliability and stratified based on whether the score was concordant or discordant among reviewers to determine factors related to discordance. RESULTS: Thirty-nine CPC scores (22.8%) were discordant (kappa: 0.66), indicating substantial agreement. When dichotomized into favorable neurologic outcome (CPC 1-2)/ unfavorable neurologic outcome (CPC 3-5), 20 (11.7%) scores were discordant (kappa: 0.70), also indicating substantial agreement. Patients discharged home (as opposed to nursing/other care facility) and patients with suspected cardiac etiology of arrest were statistically more likely to have concordant scores. For the quality improvement database, patients with discordant scores had a statistically higher median CPC score than those with concordant scores. The registry had statistically lower median CPC score (CPC 1) than the quality improvement database (CPC 2); p\u3c0.01 for statistical significance. CONCLUSIONS: CPC scores have substantial inter-rater reliability, which is reduced in patients who have worse outcomes, have a non-cardiac etiology of arrest, and are discharged to a location other than home