Defibrillation

Introduction: Survival rates from out-of-hospital cardiac arrest significantly improve when high-quality cardiopulmonary resuscitation (CPR) is performed. Despite sudden cardiac arrest being a leading cause of death in many parts of the world, no studies have determined the quality of CPR delivery by Emergency Medical Services (EMS) personnel in South Africa. The aim of this study was to determine the quality of CPR provision by EMS staff in a simulated setting. Methods: A descriptive study design was used to determine competency of CPR among intermediate-qualified EMS personnel. Theoretical knowledge was determined using a multiple-choice questionnaire, and psychomotor skills were video-recorded then assessed by independent reviewers. Correlational and regression analysis were used to determine the effect of demographic information on knowledge and skills. Results: Overall competency of CPR among participants (n = 114) was poor: median knowledge was 50%; median skill 33%. Only 25% ...

Patients with nonischemic dilated cardiomyopathy (DCM) may be at lower risk for ventricular arrhythmias compared with those with ischemic cardiomyopathy (ICM). In addition, DCM has been identified as a predictor of positive response to cardiac resynchronization therapy (CRT). The aim of this study was to investigate the impact of an additional implantable cardioverter-defibrillator over CRT, according to underlying heart disease, in a large study group of primary prevention patients with heart failure. This was an observational, multicenter, European cohort study of 5,307 consecutive patients with DCM or ICM, no history of sustained ventricular arrhythmias, who underwent CRT implantation with (n = 4,037) or without (n = 1,270) a defibrillator. Propensity-score and cause-of-death analyses were used to compare outcomes. After a mean follow-up period of 41.4 ± 29.0 months, patients with ICM had better survival when receiving CRT with a defibrillator compared with those who received CRT...

European Resuscitation Council Guidelines for Resuscitation 2010 and Advanced Life Support Provider Course teaches that the open oxygen supply must be removed from the patient during defibrillation to the distance of minimum of 1 meter. Scientific articles describe few incidents of fire during defibrillation in oxygen – enriched atmospheres. It was performed a series of measurement of the oxygen concentration in the ambulance vehicle of 10 cubic meters. The measurements were made in parked vehicle. Patient was seated on the stretchers and oxygen was applied with oxygen mask on high flow (15 l per minute). The oxygen concentration was measured on different places in the ambulance car – the patient's face, on the chest, on the wall in front of the car, on the wall in the rear and on the celling. We measured temperature, atmospheric pressure and humidity together with oxygen concentration. The result of our study showed that the oxygen concentration has risen from 20.9 % at all locations of the ambulance. In certain locations the concentration has increased at least to 30 %. It has prepared recommendations for defibrillation during oxygen administration according to the literature and our study.