Emergency Medicine Commons^™

Bystander Performance Using Automated External Defibrillators During Simulated Cardiac Arrest, Richard N. Bradley, Lynda M. Schoenstein, Wesley H. Hamilton, Mark R. Boyle

Richard N Bradley

Objective: Automated external defibrillators (AEDs) are becoming widely available to the public. This study examined the hypothesis that less than 75% of the general population can defibrillate using an AED in less than three minutes.

Methods: This was a survey of the behavior of individuals over age 12 in a major airport on Jan. 2–3, 2003. After obtaining consent, an investigator told the subject that he/she was walking down the concourse and saw a person collapse. The subject demonstrated his/her response, using only a telephone and an AED simulating ventricular fibrillation. Data were analyzed using a one-sample test of proportions. …

Cardiopulmonary Resuscitation With Rescue Breathing Is Superior To Hands-Only Cardiopulmonary Resuscitation For Children And Infants: Results Of A Systematic Review, Joseph W. Rossano, Richard N. Bradley

Richard N Bradley

Introduction

Evidence supports teaching hands-only CPR for the initial treatment of cardiac arrest in adults. Unlike adults, however, children and infants with cardiac arrest are more likely to have non-cardiac causes.

Hypothesis: The objective of this project was to conduct a structured literature review to answer the question, “In children and infants with cardiac arrest treated in an out-of-hospital setting, does compression-only CPR, alone or with supplemental oxygen, compared to CPR with rescue breathing lead to improved outcomes?”

Results

Sixty-nine records were identified and screened. Fifty-four of these did not meet inclusion/exclusion criteria, leaving fifteen full-text articles that we assessed …

Existing Research Is Inadequate For The Development Of Guidelines For The Basic Lifesupport Management Of Airway Obstruction In Adults: Results Of A Systematic Review, Richard N. Bradley, Joseph W. Rossano, Siobán Kennedy

Richard N Bradley

Introduction

There has been considerable controversy and several changes in guidelines for the basic life support (BLS) management of choking since the introduction of the Heimlich procedure in 1974.

Hypothesis: The objective of this project was to conduct a structured literature review to answer the question, “For adults, either conscious or unconscious, with obstructed airway, does any specific resuscitation techniques compared to currently recommended techniques, lead to different outcomes?”

Results

We identified 475 records after duplicates were removed; we screened all of these and excluded 454. This left 22 full-text articles which we assessed for eligibility; we excluded 19 of …

Arc Sac Advisory Pulse Check For Cardiac Arrest, Sarah Clarke, Richard N. Bradley, Siobán Kennedy

Richard N Bradley

One good quality study (LOE 4) supports omitting a pulse check after defibrillation for patients in cardiac arrest.

One fair quality study (LOE 4) opposes the performance of simultaneous as opposed to sequential pulse and breathing check to determine cardiac arrest.

There is insufficient evidence to support a recommendation on the preferred method for the initial determination of cardiac arrest.

CPR courses should specifically teach the recognition of agonal breathing and the understanding that agonal breathing is not normal breathing and that it indicates the need for CPR.

Environmental Toxins: Biological, Chemical And Radiological Terrorism, Richard N. Bradley

Richard N Bradley

Children have greater risk of harm than adults after exposure to chemical, biological or radiological weapons, as may be seen following some acts of terrorism. This chapter reviews potential chemical agents, separating them into four categories: nerve agents, blister agents, cyanides, and choking agents. It reviews both recognition and treatment. The chapter also reviews symptoms, modes of transmission and treatment for the following biological agents: smallpox, plague, tularemia, anthrax, botulism, and viral hemorrhagic fevers.

Smallpox, Richard N. Bradley

Richard N Bradley

Description Viral infection of the human respiratory tract. Causes Infection by variola virus. Risk Factors Exposure to a biological warfare or bioterror attack or contact with an infected person. Symptoms

Fever, cough and body aches, followed by a spotted, bumpy rash.

Diagnosis

Confirmed by testing blood or the fluid from the blisters.

Treatments

None currently approved but experts are testing some medications.

Pathogenesis

The virus enters and multiplies in the respiratory passages.

Prevention

Avoid those with the disease. During an outbreak a vaccine is available that will prevent the disease or lessen its severity.

Epidemiology

Completely eradicated from nature, but …

Untrained Volunteers Are Marginally Effective In Delivering Public Access Defibrillation, Richard N. Bradley, Lynda J. Schoenstein, Mohhamad Alshanti

Richard N Bradley

Study objectives: This study analyzed the behavior of untrained volunteers when presented with a simulated cardiac arrest and an automated external defibrillator (AED). The primary hypothesis of this study was that volunteers could, with no advance training, operate an AED to deliver a defibrillation to a mannequin in 3 minutes or less at least 75% of the time. The secondary hypothesis was that this population would perform all of the tasks considered essential in AED use (establish unresponsiveness, check for breathing, give 2 rescue breaths, check for pulse, apply electrodes correctly, clear patient, activate emergency medical services (EMS) response, and …

Chemical & Biological Weapons Reference Chart, Richard N. Bradley

Richard N Bradley

Health Care Providers' Quick Reference Chart to Biological and Chemical Weapons. Includes symptoms and treatment for Nerve Agents (Tabun, Sarin, Soman, and VX), Cyanides, Vesicants (Blister Agents including Mustard and Lewisite), Pulmonary Intoxicants (including chlorine and phosgene), and Riot Control Agents (pepper spray and Mace). Also includes information on detection and treatment for Biological Agents, including Anthrax, Cholera, Plague, Tularemia, Q Fever, Smallpox, Viral encephalitides, Viral hemorrhagic fevers, Botulism, Staphlococcus enterotoxin B, and Ricin.