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"Pad Placement" AND "Emergency"

Colin R Bell, Adam Szulewski, Steven C Brooks
ABSTRACTDual sequential external defibrillation (DSED) is the process of near simultaneous discharge of two defibrillators with differing pad placement to terminate refractory arrhythmias. Previously used in the electrophysiology suite, this technique has recently been used in the emergency department and prehospital setting for out-of-hospital cardiac arrest (OHCA). We present a case of successful DSED in the emergency department with neurologically intact survival to hospital discharge after refractory ventricular fibrillation (RVF) and review the putative mechanisms of action of this technique...
September 2018: CJEM
Paul C Mullan, Niall H Cochrane, James M Chamberlain, Randall S Burd, Fawn D Brown, Lauren E Zinns, Kristen M Crandall, Karen J O'Connell
STUDY OBJECTIVE: Guideline committees recommend postresuscitation debriefings to improve performance. "Hot" postresuscitation debriefings occur immediately after the event and rely on team recall. We assessed the ability of resuscitation teams to recall their performance in team-based, hot debriefings in a pediatric emergency department (ED), using video review as the criterion standard. We hypothesized that debriefing accuracy will improve during the course of the study. METHODS: Resuscitation physician and nurse leaders cofacilitated debriefings after ED resuscitations involving cardiopulmonary resuscitation (CPR) or intubation...
September 2017: Annals of Emergency Medicine
Erica Johnson, Bradley J Austin, Ethan Inlander, Cory Gallipeau, Michelle A Evans-White, Sally Entrekin
Oil and gas extraction in shale plays expanded rapidly in the U.S. and is projected to expand globally in the coming decades. Arkansas has doubled the number of gas wells in the state since 2005 mostly by extracting gas from the Fayetteville Shale with activity concentrated in mixed pasture-deciduous forests. Concentrated well pads in close proximity to streams could have adverse effects on stream water quality and biota if sedimentation associated with developing infrastructure or contamination from fracturing fluid and waste occurs...
October 15, 2015: Science of the Total Environment
José G Cabañas, J Brent Myers, Jefferson G Williams, Valerie J De Maio, Michael W Bachman
Abstract Background. Ventricular fibrillation (VF) is considered the out-of-hospital cardiac arrest (OOHCA) rhythm with the highest likelihood of neurologically intact survival. Unfortunately, there are occasions when VF does not respond to standard defibrillatory shocks. Current American Heart Association (AHA) guidelines acknowledge that the data are insufficient in determining the optimal pad placement, waveform, or energy level that produce the best conversion rates from OOHCA with VF. Objective. To describe a technique of double sequential external defibrillation (DSED) for cases of refractory VF (RVF) during OOHCA resuscitation...
January 2015: Prehospital Emergency Care
Kiesha N Fraser, Maybelle M Kou, John M Howell, Kaidi T Fullerton, Charles Sturek
PURPOSE: Approximately 14 000 pediatric out-of-hospital arrests occur annually. With this significant number and the diversity in the training backgrounds of medical providers, correct choice and placement of defibrillator pads are imperative to ensure maximum efficacy. METHODS: One hundred fifty-two emergency medical care providers from 6 medical fields were recruited for the study. Each participant answered a series of questions to ascertain baseline knowledge of correct defibrillator pad choice and placement in 2 scenarios with mannequins weighted less than 15 kg and more than 15kg...
September 2014: American Journal of Emergency Medicine
Gianluca Del Rossi, Glenn R Rechtine, Bryan P Conrad, MaryBeth Horodyski
BACKGROUND: As prehospital emergency rescuers prepare cervical spine-injured adult patients for immobilization and transport to hospital, it is essential that patients be placed in a favorable position. Previously, it was recommended that patients with cervical spine injuries be immobilized in a slightly flexed position using pads placed beneath the head. However, it is unknown how neck flexion created with pad placement affects the unstable spine. OBJECTIVE: To determine the effects of three different head positions on the alignment of unstable vertebral segments...
September 2013: Journal of Emergency Medicine
F Lee
Defibrillation may be needed in witnessed and unwitnessed cardiac arrests. Cardiopulmonary resuscitation (CPR) must be initiated and defibrillation administered without delay. Every shock cycle includes 1-2 minutes of CPR followed by rhythm analysis. The energy level for biphasic defibrillation of ventricular fibrillation is 150 J with possible step-wise escalation to 360 J. All healthcare workers need to learn and be authorised to use an automated external defibrillator (AED). In addition, all ambulances must be equipped with AEDs when transporting patients...
August 2011: Singapore Medical Journal
Malcolm Woollard, Richard Whitfield, Robert G Newcombe, Michael Colquhoun, Norman Vetter, Douglas Chamberlain
AIM: To determine the optimal refresher training interval for lay volunteer responders in the English National Defibrillator Programme who had previously undertaken a conventional 4-h initial class and a first refresher class at 6 months. METHODS: Subjects were randomised to receive either two additional refresher classes at intervals of 7 and 12 months or one additional refresher class after 12 months. RESULTS: Greater skill loss had occurred when the second refresher class was undertaken at 12 compared with 7 months...
November 2006: Resuscitation
M Rigo, S Negrini, H R Weiss, T B Grivas, T Maruyama, T Kotwicki
BACKGROUND: The effectiveness of orthotic treatment continues to be controversial in international medical literature due to differences in the reported results and conclusions of various studies. Heterogeneity of the samples has been suggested as a reason for conflicting results. Besides the obvious theoretical differences between the brace concepts, the variability in the technical factors can also explain the contradictory results between same brace types. This paper will investigate the degree of variability among responses of scoliosis specialists from the Brace Study Ground of the International Society on Scoliosis Orthopedic and Rehabilitation Treatment SOSORT...
July 20, 2006: Scoliosis
Anthony D Andre, Dawn B Jorgenson, Jamie A Froman, David E Snyder, Jeanne E Poole
OBJECTIVE: For automated external defibrillators (AEDs) to be practical for broad public use, responders must be able to use them safely and effectively. This study's objective was to determine whether untrained laypersons could accurately follow the visual and voice prompt instructions of an AED. METHODS: Each of four different AED models (AED1, AED2, AED3, and AED4) was randomly assigned to a different group of 16 untrained volunteers in a simulated cardiac arrest...
July 2004: Prehospital Emergency Care
J W Gundry, K A Comess, F A DeRook, D Jorgenson, G H Bardy
BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is strongly influenced by time to defibrillation. Wider availability of automated external defibrillators (AEDs) may decrease response times but only with increased lay use. Consequently, this study endeavored to improve our understanding of AED use in naive users by measuring times to shock and appropriateness of pad location. We chose sixth-grade students to simulate an extreme circumstance of unfamiliarity with the problem of OHCA and defibrillation...
October 19, 1999: Circulation
P D Chapman, R A Stratbucker, D P Schlageter, S P Pruzina
STUDY OBJECTIVES: To assess the safety and efficacy of transcutaneous cardiac pacing using low-impedance defibrillation-type, self-adhesive polymer electrode pads positioned in the same anatomic sites typical of such pad placement in emergency defibrillation attempts. DESIGN: Prospective, randomized, single-blinded normal subject investigation. METHODS: Thirty healthy unmedicated adult volunteers of both sexes were paced transcutaneously to the threshold of capture and beyond by an intensity factor of 125%...
December 1992: Annals of Emergency Medicine
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