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Airway cardiac arrest

Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Dustin T Money, Yunge Zhao, Mark H Stoler, Christine L Lau, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
OBJECTIVE: Critical organ shortages have resulted in ex vivo lung perfusion gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of donation after circulatory death organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation during ex vivo lung perfusion improves lung function after transplantation. METHODS: Two groups (n = 4 animals/group) of porcine donation after circulatory death donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of ex vivo lung perfusion rehabilitation with standard conventional volume-based ventilation or pressure-based airway pressure release ventilation...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
E Sh Bairambekov, A V Pevzner, A Yu Litvin, O A Fomicheva
The case history of a 46-year-old patient with obstructive sleep apnea syndrome was analyzed. The examination revealed fourth-degree obesity, prior myocardial infarction, persistent atrial fibrillation with nocturnal asystoles lasting as long as 14.3 sec. During selected drug therapy and regular application of secondary ventilation (continuous positive airway pressure (CPAP) therapy) used to correct breathing problems, there was a reduction in the signs of circulatory deficiency, cessation of cardiac pauses, and recovery of sinus rhythm...
2016: Terapevticheskiĭ Arkhiv
Lars W Andersen, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Anne V Grossestreuer, Tobias Kurth, Michael W Donnino
Importance: Tracheal intubation is common during pediatric in-hospital cardiac arrest, although the relationship between intubation during cardiac arrest and outcomes is unknown. Objective: To determine if intubation during pediatric in-hospital cardiac arrest is associated with improved outcomes. Design, Setting, and Participants: Observational study of data from United States hospitals in the Get With the Guidelines-Resuscitation registry...
October 4, 2016: JAMA: the Journal of the American Medical Association
Jodi Taylor, Sarah Black, Stephen J Brett, Kim Kirby, Jerry P Nolan, Barnaby C Reeves, Maria Robinson, Chris A Rogers, Lauren J Scott, Adrian South, Elizabeth A Stokes, Matthew Thomas, Sarah Voss, Sarah Wordsworth, Jonathan R Benger
Health outcomes after out of hospital cardiac arrest (OHCA) are extremely poor, with only 7-9% of patients in the United Kingdom (UK) surviving to hospital discharge. Currently emergency medical services (EMS) use either tracheal intubation or newer supraglottic airway devices (SGAs) to provide advanced airway management during OHCA. Equipoise between the two techniques has led to calls for a well-designed randomised controlled trial. The primary objective of the AIRWAYS-2 trial is to assess whether the clinical effectiveness of the i-gel, a second-generation SGA, is superior to tracheal intubation in the initial airway management of OHCA patients in the UK...
September 30, 2016: Resuscitation
Emmanuel Caruana, Sylvie Chevret, Romain Pirracchio
BACKGROUND: The benefit of cricoid pressure during tracheal intubation is still debated and, due to its potential negative impact on laryngeal views, its routine use is questioned. The goal of this study was to estimate its impact on laryngeal view. METHODS: All patients intubated in the prehospital setting were included. Three different propensity score (PS) models were used and compared in terms of the balance achieved between those patients who received cricoid pressure and those who did not...
September 30, 2016: Emergency Medicine Journal: EMJ
Mazen El Sayed, Hani Tamim, Ahel Al-Hajj Chehadeh, Amin A Kazzi
BACKGROUND: Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction...
September 19, 2016: Prehospital and Disaster Medicine
Karl Sporer, Michael Jacobs, Leo Derevin, Sue Duval, James Pointer
OBJECTIVE: To assess system-wide implementation of specific therapies focused on perfusion during cardiopulmonary resuscitation (CPR) and cerebral recovery after Return of Spontaneous Circulation (ROSC). METHODS: Before and after retrospective analysis of an out-of-hospital cardiac arrest database. Implementation trial in the urban/suburban community of Alameda County, California, USA, population 1.6 million, from November 2009-December 2012. Adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA) who received CPR and/or defibrillation...
September 14, 2016: Prehospital Emergency Care
M B Avnstorp, P V F Jensen, T Dzongodza, N Matinhira, C Chidziva, J Melchiors, C Von Buchwald
BACKGROUND: In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors into a video-guided simulation training programme on emergency cricothyroidotomy. This paper presents the positive effect of this training, illustrated by two case reports. CASE REPORTS: A 56-year-old female presented with upper airway obstruction due to a rapidly progressing infectious swelling of the head and neck progressing to cardiac arrest...
September 9, 2016: Journal of Laryngology and Otology
Jose V Nable, Benjamin J Lawner, William J Brady
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services systems. The provision of high-quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature. In addition, the review will highlight important areas of clinical practice which represent some of the many intersections between emergency medicine and emergency medical services such as cardiac arrest and airway management...
July 19, 2016: American Journal of Emergency Medicine
Yuko Ono, Takuya Sugiyama, Yasuyuki Chida, Tetsuya Sato, Hiroaki Kikuchi, Daiji Suzuki, Masakazu Ikeda, Koichi Tanigawa, Kazuaki Shinohara
BACKGROUND: A reduction in medical staff such as occurs in hospitals during nights and weekends (off hours) is associated with a worse outcome in patients with several unanticipated critical conditions. Although difficult airway management (DAM) requires the simultaneous assistance of several appropriately trained medical caregivers, data are scarce regarding the association between off-hour presentation and endotracheal intubation (ETI)-related adverse events, especially in the trauma population...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Marie-Sophie Grave, Fritz Sterz, Alexander Nürnberger, Stergios Fykatas, Mathias Gatterbauer, Albert Friedrich Stättermayer, Andreas Zajicek, Reinhard Malzer, Dieter Sebald, Raphael van Tulder
We investigated feasibility and safety of the RhinoChill (RC) transnasal cooling system initiated before achieving a protected airway during cardiopulmonary resuscitation (CPR) in a prehospital setting.In out-of-hospital cardiac arrest (OHCA), transnasal evaporative cooling was initiated during CPR, before a protected airway was established and continued until either the patient was declared dead, standard institutional systemic cooling methods were implemented or cooling supply was empty. Patients were monitored throughout the hypothermia period until either death or hospital discharge...
August 2016: Medicine (Baltimore)
Jacquelyn Adams, Jose R Cepeda Brito, Lauren Baker, Patrick G Hughes, M David Gothard, Michele L McCarroll, Jocelyn Davis, Angela Silber, Rami A Ahmed
Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT) and confidence surveys (CS) were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations...
2016: Critical Care Research and Practice
Carmen Sulton, Courtney McCracken, Harold K Simon, Kiran Hebbar, Jason Reynolds, Joseph Cravero, Michael Mallory, Pradip Kamat
OBJECTIVES: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists. METHODS: Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified...
September 2016: Hospital Pediatrics
Katharina Lenherr, Stephan Budweiser
Many physicians are working in intensive care and are not additionally anaesthesiological experienced. The situation having to perform an emergency in intubation is often feel anxious. Significant complications, such as severe hypoxemia (25%), life-threatening cardiovascular events (40%) or cardiac arrest (2%) may occur during intubation on ICU. The physician must have a clear strategy in preparation and implemention of emergency intubation. It is equally important to perform an alternative airway management when intubation is difficult...
August 2016: Deutsche Medizinische Wochenschrift
Bryan Choi, Nicholas Asselin, Catherine C Pettit, Max Dannecker, Jason T Machan, Derek L Merck, Lisa H Merck, Selim Suner, Kenneth A Williams, Gregory D Jay, Leo Kobayashi
INTRODUCTION: Effective resuscitation of out-of-hospital cardiac arrest (OHCA) patients is challenging. Alternative resuscitative approaches using electromechanical adjuncts may improve provider performance. Investigators applied simulation to study the effect of an experimental automation-assisted, goal-directed OHCA management protocol on EMS providers' resuscitation performance relative to standard protocols and equipment. METHODS: Two-provider (emergency medical technicians (EMT)-B and EMT-I/C/P) teams were randomized to control or experimental group...
August 9, 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Seungmin Jeong, Ki Ok Ahn, Sang Do Shin
OBJECTIVE: The objective of this meta-analysis was to compare the benefits of prehospital advanced airway management (AAM) and basic airway management (BAM) for out-of-hospital cardiac arrest (OHCA) patients. METHODS: Two investigators performed a systematic review of PubMed, EMBASE, and the Cochrane Database to identify all peer-reviewed articles relevant to this meta-analysis. We included all articles describing emergency medical system-treated nontraumatic OHCAs; specifically, all articles that described intervention of the prehospital AAM type were considered...
July 19, 2016: American Journal of Emergency Medicine
Alexander Olaussen, Matthew Shepherd, Ziad Nehme, Karen Smith, Paul A Jennings, Stephen Bernard, Biswadev Mitra
INTRODUCTION: Consciousness may occur during effective management of cardiac arrest and ranges from eye opening to interfering with rescuers' resuscitation attempts. Reported cases in the medical literature appear scant compared to anecdotal reports. The aim of this study was to evaluate health care providers' experience with consciousness during cardio-pulmonary resuscitation (CPR). METHODS: A cross-sectional survey of 100 experienced health care professionals, including doctors, nurses and paramedics...
July 28, 2016: Australasian Emergency Nursing Journal: AENJ
Graham Nichol, Leonard A Cobb, Lihua Yin, Charles Maynard, Michele Olsufka, Jonathan Larsen, Andrew M McCoy, Michael R Sayre
BACKGROUND: Treatment of out-of-hospital cardiac arrest (OHCA) requires prompt intervention. Better outcomes are associated with briefer time from dispatch of emergency medical services (EMS) providers to arrival on scene, application of a defibrillator or insertion of an advanced airway. We assessed whether time from receipt of a call by a telecommunicator to dispatch of EMS providers was associated with outcomes. METHODS: This was a retrospective analysis of a prospective cohort study of persons who had OHCA treated by EMS providers in Seattle, WA...
October 2016: Resuscitation
Suze Dominique Bruins, Pauline Meng Choo Leong, Shin Yi Ng
INTRODUCTION: We reviewed patients with critical incidents that occurred in the post-anaesthesia care unit (PACU) at a major tertiary hospital, and the effect of these incidents on PACU length of stay and discharge disposition was assessed. METHODS: A retrospective review was conducted of patients in the PACU over a two-year period from 24 June 2011 to 23 August 2013. Data on critical incidents were recorded in the administrative database using a standardised data form...
July 21, 2016: Singapore Medical Journal
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