tailieunhanh - Báo cáo y học: " Focused nurse-defibrillation training: a simple and cost-effective strategy to improve survival from in-hospital cardiac arrest"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Focused nurse-defibrillation training: a simple and cost-effective strategy to improve survival from in-hospital cardiac arrest | Stewart Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 42 http content 18 1 42 SCANDINAVIAN JOURNAL OF t emergency medicine COMMENTARY Open Access Focused nurse-defibrillation training a simple and cost-effective strategy to improve survival from in-hospital cardiac arrest John A Stewart Abstract Time to first defibrillation is widely accepted to correlate closely with survival and recovery of neurological function after cardiac arrest due to ventricular fibrillation or ventricular tachycardia. Focused training of a cadre of nurses to defibrillate on their own initiative may significantly decrease time to first defibrillation in cases of in-hospital cardiac arrest outside of critical care units. Such a program may be the best single strategy to improve in-hospital survival simply and at reasonable cost. Introduction Survival from in-hospital cardiac arrest has not improved over the half-century since the advent of basic cardiopulmonary resuscitation CPR and defibrillation 1 2 . Survival rates remain about 18 at best and survival is lower on general units than in critical-care areas 3 . Explanations for this lack of progress often invoke comorbidity 2 and proposals for change have frequently focused on preventing presumably futile resuscitation attempts by means of do-not-resuscitate orders 4 . Medical emergency teams have increasingly been implemented to respond to early signs of deterioration and prevent progression to cardiac arrest 5 . But tachyar-rythmic arrests ventricular fibrillation VF and ventricular tachycardia VT are typically sudden and this subset of arrests comprises the cases with a real chance of survival-if defibrillation is accomplished quickly. The most important change in out-of-hospital resuscitation over the past quarter-century has been the renewed focus on early defibrillation by first responders and the best approach to improving in-hospital survival may be simply to bring effective early .