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https://www.readbyqxmd.com/read/28409655/9-1-1-triage-of-non-traumatic-chest-pain-association-with-hospital-diagnosis
#1
Greg Scott, Jeff J Clawson, Isabel Gardett, Meghan Broadbent, Nathan Williams, Conrad Fivaz, Gigi Marshall, Tracey Barron, Christopher Olola
OBJECTIVE: Chest pain is one of the most common reasons people seek emergency care-and one of the most critical. In the United States, chest pain is the second most common reason for emergency department (ED) visits. A patient's primary complaint of "chest pain" may reflect a broad range of underlying causes; therefore, it is important that emergency medical service (EMS) agencies gain a thorough understanding of these cases, beginning with the initial management of chest pain in the 9-1-1 center...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28343957/adult-out-of-hospital-cardiac-arrest-in-philadelphia-from-2008-2012-an-epidemiological-study
#2
David F Gaieski, Anish K Agarwal, Benjamin S Abella, Robert W Neumar, Crawford Mechem, Sarah Wallace Cater, Frances S Shofer, Marion Leary, William P Pajerowski, Lance B Becker, Brendan Carr, Raina Merchant, Roger A Band
BACKGROUND: Wide variation in out-of-hospital cardiac arrest (OHCA) survival has been reported, with low survival in urban settings. We sought to describe the epidemiology of OHCA in Philadelphia, Pennsylvania, the fifth largest U.S. city, and identify potential areas for targeted interventions to improve survival. METHODS AND RESULTS: Retrospective chart review of adult, non-traumatic, OHCA occurring in Philadelphia between 2008 and 2012. We determined incidence and epidemiological factors including: demographics, initial cardiac rhythm, bystander cardiopulmonary resuscitation, automated external defibrillator use, return of spontaneous circulation and 30-day survival...
March 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28315585/eye-movement-during-recall-reduces-objective-memory-performance-an-extended-replication
#3
Arne Leer, Iris M Engelhard, Bert Lenaert, Dieter Struyf, Bram Vervliet, Dirk Hermans
Eye Movement Desensitization and Reprocessing (EMDR) therapy for posttraumatic stress disorder involves making eye movements (EMs) during recall of a traumatic image. Experimental studies have shown that the dual task decreases self-reported memory vividness and emotionality. However valuable, these data are prone to demand effects and little can be inferred about the mechanism(s) underlying the observed effects. The current research aimed to fill this lacuna by providing two objective tests of memory performance...
March 9, 2017: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/28163233/the-impact-of-first-responder-turnout-and-curb-to-care-intervals-on-survival-from-out-of-hospital-cardiac-arrest
#4
Nicolaas P DeRuyter, Sofia Husain, Lihua Yin, Michele Olsufka, Andrew M McCoy, Charles Maynard, Leonard A Cobb, Thomas D Rea, Michael R Sayre
PURPOSE: Patients with out-of-hospital cardiac arrest (OHCA) more likely survive when emergency medical services (EMS) arrive quickly. We studied time response elements in OHCA with attention to EMS intervals before wheels roll and after wheels stop to understand their contribution to total time response and clinical outcome. METHODS: We analyzed EMS responses to OHCA from 2009-2014 in an urban, fire department based system. The Call-to-Care Interval, from call receipt to hands-on EMS care, was comprised of four time intervals: 1) call received to EMS notification (Activation), 2) EMS notification to vehicle wheels rolling (Turnout), 3) wheels rolling to arrival at scene (Travel), and 4) arrival at scene to hands-on EMS care (Curb-to-Care)...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28076734/effect-of-a-mass-media-campaign-on-ambulance-use-for-chest-pain
#5
Ziad Nehme, Peter A Cameron, Muhammad Akram, Harry Patsamanis, Janet E Bray, Ian T Meredith, Karen Smith
OBJECTIVES: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28012882/out-of-hospital-cardiac-arrest-without-return-of-spontaneous-circulation-in-the-field-who-are-the-survivors
#6
Yan Xiong, Hong Zhan, Yuanzheng Lu, Kaipan Guan, Ngozi Okoro, Denise Mitchell, Megan Dwyer, Auna Leatham, Gilberto Salazar, Xiaoxing Liao, Ahamed Idris
BACKGROUND: Return of spontaneous circulation (ROSC) in the field is a vital determinant contributing to survival from out-of-hospital cardiac arrest (OHCA). However, nearly one third of survivors at the Dallas-Fort Worth (DFW) Resuscitation Outcomes Consortium (ROC) site did not obtain ROSC in the field. METHODS: A retrospective, observational analysis was performed on all adult patients with non-traumatic OHCA treated on scene and transported to hospital, who did not gain ROSC in the field at DFW ROC site between 2006 through 2011...
March 2017: Resuscitation
https://www.readbyqxmd.com/read/28008683/non-traumatic-out-of-hospital-cardiac-arrest-in-rural-taiwan-a-retrospective-study
#7
Shih-Chang Hung, Ching-Yi Mou, Hung-Chang Hung, Shih-Wei Lai, Chun-Chih Chen, Jui-Wen Lin, Ssu-Hung Wang, Chung-Kuang Chen, Kai-Chun Cheng
OBJECTIVE: Out-of-hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan. DESIGN: A retrospective observational study. SETTING: All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan. PARTICIPANTS: All OHCA patients from May 2011 to March 2013...
December 23, 2016: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/27923115/a-comparison-of-the-universal-tor-guideline-to-the-absence-of-prehospital-rosc-and-duration-of-resuscitation-in-predicting-futility-from-out-of-hospital-cardiac-arrest
#8
Ian R Drennan, Erin Case, P Richard Verbeek, Joshua C Reynolds, Zachary D Goldberger, Jamie Jasti, Mark Charleston, Heather Herren, Ahamed H Idris, Paul R Leslie, Michael A Austin, Yan Xiong, Robert H Schmicker, Laurie J Morrison
INTRODUCTION: The Universal Termination of Resuscitation (TOR) Guideline accurately identifies potential out-of-hospital cardiac arrest (OHCA) survivors. However, implementation is inconsistent with some Emergency Medical Service (EMS) agencies using absence of return of spontaneous circulation (ROSC) as sole criterion for termination. OBJECTIVE: To compare the performance of the Universal TOR Guideline with the single criterion of no prehospital ROSC. Second, to determine factors associated with survival for patients transported without a ROSC...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#9
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27760796/association-between-duration-of-resuscitation-and-favorable-outcome-after-out-of-hospital-cardiac-arrest-implications-for-prolonging-or-terminating-resuscitation
#10
Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest, and case features justifying longer or shorter durations are ill defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in out-of-hospital cardiac arrest using a large, multicenter cohort. METHODS: This was a secondary analysis of a North American, single-blind, multicenter, cluster-randomized, clinical trial (ROC-PRIMED [Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed]) of consecutive adults with nontraumatic, emergency medical services-treated out-of-hospital cardiac arrest...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27697605/design-and-implementation-of-the-airways-2-trial-a-multi-centre-cluster-randomised-controlled-trial-of-the-clinical-and-cost-effectiveness-of-the-i-gel-supraglottic-airway-device-versus-tracheal-intubation-in-the-initial-airway-management-of-out-of-hospital
#11
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...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27630031/continuous-quality-improvement-efforts-increase-survival-with-favorable-neurologic-outcome-after-out-of-hospital-cardiac-arrest
#12
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
https://www.readbyqxmd.com/read/27405926/the-cpr-outcomes-of-online-medical-video-instruction-versus-on-scene-medical-instruction-using-simulated-cardiac-arrest-stations
#13
Chaiyaporn Yuksen, Sorravit Sawatmongkornkul, Jarupol Tuangsirisup, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
BACKGROUND: Non-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures. There are limited data on the effects of telemedicine in cardiac arrest situations in the literature particularly in Asian settings. METHODS: This study was conducted by using two simulated cardiac arrest stations during the 2014 annual Thai national conference in emergency medicine...
July 12, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27352210/prehospital-factors-associated-with-an-acute-life-threatening-condition-in-non-traumatic-chest-pain-patients-a-systematic-review
#14
REVIEW
Kristoffer Wibring, Johan Herlitz, Lennart Christensson, Markus Lingman, Angela Bång
BACKGROUND: Chest pain is a common symptom among patients contacting the emergency medical services (EMS). Risk stratification of these patients is warranted before arrival in hospital, regarding likelihood of an acute life-threatening condition (LTC). AIM: To identify factors associated with an increased risk of acute LTC among patients who call the EMS due to non-traumatic chest pain. METHODS: Several databases were searched for relevant articles...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27296956/sex-differences-in-the-prehospital-management-of-out-of-hospital-cardiac-arrest
#15
Bryn E Mumma, Temur Umarov
BACKGROUND: Sex differences exist in the diagnosis and treatment of several cardiovascular diseases. Our objective was to determine whether sex differences exist in the use of guideline-recommended treatments in out-of-hospital cardiac arrest (OHCA). METHODS: We included adult patients with non-traumatic OHCA treated by emergency medical services (EMS) in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed (ROC PRIMED) database during 2007-2009...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/27131844/comparison-of-team-focused-cpr-vs-standard-cpr-in-resuscitation-from-out-of-hospital-cardiac-arrest-results-from-a-statewide-quality-improvement-initiative
#16
David A Pearson, R Darrell Nelson, Lisa Monk, Clark Tyson, James G Jollis, Christopher B Granger, Claire Corbett, Lee Garvey, Michael S Runyon
BACKGROUND: Team-focused CPR (TFCPR) is a choreographed approach to cardiopulmonary resuscitation (CPR) with emphasis on minimally interrupted high-quality chest compressions, early defibrillation, discourages endotracheal intubation and encourages use of the bag-valve-mask (BVM) and/or blind-insertion airway device (BIAD) with a ventilation rate of 8-10 breaths/min to minimize hyperventilation. Widespread incorporation of TFCPR in North Carolina (NC) EMS agencies began in 2011, yet its impact on outcomes is unknown...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/27048406/good-neurological-outcome-despite-very-low-regional-cerebral-oxygen-saturation-during-resuscitation-a-prospective-preclinical-trial-in-29-patients
#17
Christian Storm, Alexander Wutzler, Lars Trenkmann, Alexander Krannich, Sabrina von Rheinbarben, Fridolin Luckenbach, Jens Nee, Natalie Otto, Tim Schroeder, Christoph Leithner
BACKGROUND: Noninvasive regional cerebral oxygen saturation (rSO2) measurement using near-infrared spectroscopy (NIRS) might inform on extent and duration of cerebral hypoxia during cardiopulmonary resuscitation (CPR). This information may be used to guide resuscitation efforts and may carry relevant early prognostic information. METHODS: We prospectively investigated non-traumatic out-of-hospital cardiac arrest (OHCA) patients on scene. NIRS was started either during CPR or shortly after (<2 min) return of spontaneous circulation (ROSC) by emergency medical service (EMS)...
April 6, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27018764/relationship-between-time-to-rosc-and-survival-in-out-of-hospital-cardiac-arrest-ecpr-candidates-when-is-the-best-time-to-consider-transport-to-hospital
#18
Brian Grunau, Joshua Reynolds, Frank Scheuermeyer, Robert Stenstom, Dion Stub, Sarah Pennington, Sheldon Cheskes, Krishnan Ramanathan, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may improve outcomes for refractory out-of-hospital cardiac arrest (OHCA). Transport of intra-arrest patients to hospital however, may decrease CPR quality, potentially reducing survival for those who would have achieved return-of-spontaneous-circulation (ROSC) with further on-scene resuscitation. We examined time-to-ROSC and patient outcomes for the optimal time to consider transport. METHODS: From a prospective registry of consecutive adult non-traumatic OHCA's, we identified a hypothetical ECPR-eligible cohort of EMS-treated patients with age ≤ 65, witnessed arrest, and bystander CPR or EMS arrival < 10 minutes...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26940662/potential-candidates-for-a-structured-canadian-ecpr-program-for-out-of-hospital-cardiac-arrest
#19
Brian Grunau, Frank Xavier Scheuermeyer, Dion Stub, Robert H Boone, Joseph Finkler, Sarah Pennington, Sarah Ann Carriere, Anson Cheung, Ruth MacRedmond, Jamil Bashir, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR), while resource-intensive, may improve outcomes in selected patients with refractory out-of-hospital cardiac arrest (OHCA). We sought to identify patients who fulfilled a set of ECPR criteria in order to estimate: (1) the proportion of patients with refractory cardiac arrest who may have benefited from ECPR; and (2) the outcomes achieved with conventional resuscitation. METHODS: We performed a secondary analysis from a 52-month prospective registry of consecutive adult non-traumatic OHCA cases from a single urban Canadian health region serving one million patients...
November 2016: CJEM
https://www.readbyqxmd.com/read/26851705/comparing-the-prognosis-of-those-with-initial-shockable-and-non-shockable-rhythms-with-increasing-durations-of-cpr-informing-minimum-durations-of-resuscitation
#20
COMPARATIVE STUDY
Brian Grunau, Joshua C Reynolds, Frank X Scheuermeyer, Robert Stenstrom, Sarah Pennington, Chris Cheung, Jennifer Li, Mona Habibi, Krishnan Ramanathan, David Barbic, Jim Christenson
AIM: There is little data to inform the appropriate duration of resuscitation attempts for out-of-hospital cardiac arrest (OHCA). We assessed the relationship of elapsed duration since commencement of resuscitation and outcomes, highlighting differences between initial shockable and non-shockable rhythms. METHODS: We examined consecutive adult non-traumatic EMS-treated OHCA in a single health region. We plotted the time-dependent accrual of patients with ROSC, as well as dynamic estimates of outcomes as a function of duration from commencement of professional resuscitation, and compared subgroups dichotomized by initial rhythm...
April 2016: Resuscitation
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