The early minutes of in-hospital cardiac arrest: Shock or CPR? A population based prospective study

<p>Abstract</p> <p>Objectives</p> <p>In the early minutes of cardiac arrest, timing of defibrillation and cardiopulmonary resuscitation during the basic life support phase (BLS CPR) is debated. Aims of this study were to provide in-hospital incidence and outcome data, and to investigate the relation between outcome and time from collapse to defibrillation, time to BLS CPR, and CPR quality.</p> <p>Methods</p> <p>Resuscitation attempts during a 3-year period at St. Olav's University Hospital (960 beds) were prospectively registered. The times between collapse and initiation of BLS CPR, and defibrillation were determined. CPR quality was assessed by the resuscitation team. The relation between these variables and outcome (short term survival and discharge) was explored using non-parametric correlation and logistic regression.</p> <p>Results</p> <p>CPR was started in a total of 223 arrests, an incidence of 77 episodes per 1000 beds per year. Return of spontaneous circulation occurred in 40%, and 29 patients (13%) survived to discharge. Median time from collapse to BLS CPR was 1 minute; CPR was judged to be of good quality in half of the episodes. CPR during the first 3 minutes in ventricular fibrillation (VF/VT) was negatively associated with survival, but later proved beneficial. For patients with non-shockable rhythms, we found no association between outcome and time to BLS or CPR quality.</p> <p>Conclusion</p> <p>Our findings indicate that defibrillation should have priority during the first 3 minutes of VF/VT. Later, patients benefit from CPR in conjunction with defibrillation. Patients presenting with non-shockable rhythms have a grave prognosis, and the outcome was not associated with time to BLS or CPR quality.</p

Pitfalls with the "chest compression-only" approach: the challenge of an unusual cause

Chest compression-only (CC-only) is now incorporated in the Norwegian protocol for dispatch guided CPR (cardiopulmonary resuscitation) in cardiac arrest of presumed cardiac aetiology

Differences in trauma team activation criteria among Norwegian hospitals

<p>Abstract</p> <p>Background</p> <p>To ensure the rapid and correct triage of patients in potential need of specialized treatment, Norwegian hospitals are expected to establish trauma teams with predefined criteria for their activation. The objective of this study was to map and describe the criteria currently in use.</p> <p>Methods</p> <p>We undertook a cross-sectional survey in the summer of 2008, using structured telephone interviews to all Norwegian hospitals that might admit severely injured patients.</p> <p>Results</p> <p>Forty-nine hospitals were included, of which 48 (98%) had a trauma team and 20 had a hospital-based trauma registry. Criteria for trauma team activation were found at 46 (94%) hospitals. No single criterion was common to all hospitals. The median number of criteria per hospital was 23 (range 8-40), with a total number of 156 and wide variation with respect to physiological "cut-off" values. The mechanism of injury was commonly in use despite a well-known, large over-triage rate.</p> <p>Conclusions</p> <p>In recent years, Norwegian hospitals have gradually established trauma teams and criteria for their activation. These criteria show considerable variation, including physiological "cut-off" values.</p

Stress in ordered systems: Ginzburg-Landau type density field theory

We present a theoretical method for deriving the stress tensor and elastic response of ordered systems within a Ginzburg-Landau type density field theory in the linear regime. This is based on spatially coarse graining the microscopic stress which is determined by the variation of a free energy with respect to mass displacements. We find simple expressions for the stress tensor for phase field crystal (PFC) models for different crystal symmetries in two and three dimensions. Using tetradic product sums of reciprocal lattice vectors, we calculate elastic constants and show that they are directly related to the symmetries of the reciprocal lattices. We also show that except for bcc lattices, there are regions of model parameters for which the elastic response is isotropic. The predicted elastic stress-strain curves are verified by numerical strain-controlled bulk and shear deformations. Since the method is independent of a reference state, it extends also to defected crystals. We exemplify this by considering an edge and screw dislocation in the simple cubic lattice

Dislocation nucleation in the phase field crystal model

We use the phase field crystal model to study nucleation of edge dislocations in two dimensions under an applied stress field. A dislocation dipole nucleates under the applied stress, consistent with Burgers vector conservation. The phase field correctly accounts for elastic energy storage prior to nucleation, and for dissipative relaxation during the nucleation event. We show that a lattice incompatibility field is a sensitive diagnostic of the location of the nucleation event, and of the Burgers vector and slip direction of the dislocations that will be nucleated above threshold. A direct calculation of the phase field energy accurately correlates with the nucleation event, as signaled by the lattice incompatibility field. We show that a Schmid-like criterion concerning the resolved stress at the nucleation site correctly predicts the critical nucleation stress. Finally, we present preliminary results for a three-dimensional, body-centered cubic lattice. The phase field allows a direct computation of the lattice incompatibility tensor for both dislocation lines and loops.Comment: 8 pages, 7 figure

Tunable anisotropic quantum rabi model via a Magnon-Spin-Qubit ensemble

The ongoing rapid progress towards quantum technologies relies on new hybrid platforms optimized for specific quantum computation and communication tasks, and researchers are striving to achieve such platforms. We study theoretically a spin qubit exchange-coupled to an anisotropic ferromagnet that hosts magnons with a controllable degree of intrinsic squeezing. We find this system to physically realize the quantum Rabi model from the isotropic to the Jaynes-Cummings limit with coupling strengths that can reach the deep-strong regime. We demonstrate that the composite nature of the squeezed magnon enables concurrent excitation of three spin qubits coupled to the same magnet. Thus, three-qubit GreenbergerHorne-Zeilinger and related states needed for implementing Shor’s quantum error-correction code can be robustly generated. Our analysis highlights some unique advantages offered by this hybrid platform, and we hope that it will motivate corresponding experimental effort