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Pulseless electrical activity

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https://www.readbyqxmd.com/read/29439300/angiovac-system-used-as-an-adjunct-treatment-for-intra-cardiac-lead-and-valvular-vegetations
#1
Vishesh Kumar, Shahbaz A Malik, Maryam Sheikh, Adam Stys
Infections are known complications of cardiovascular implantable electronic devices (CIEDs). We describe a case of a 62-year-old male who presented with pulseless electrical activity (PEA) cardiac arrest and respiratory failure. He had a history of cardiac resynchronization device and defibrillator (CRT-D) implantation for nonischemic cardiomyopathy. After resuscitation, he was found to have methicillin sensitive Staphylococcus aureus (MSSA) bacteremia on blood culture and large vegetations on the CRT-D lead and tricuspid valve found on echocardiography...
January 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/29437732/fatal-air-embolism-following-local-anaesthetisation-does-needle-size-matter
#2
Faiza Khalid, Sofiya Rehman, Rania AbdulRahman, Shikha Gupta
A 76--year--old male cigarette smoker presented with a 2-week history of cough and haemoptysis. Chest CT on admission revealed multiple new lung nodules concerning for malignancy. CT--guided biopsy of the nodule in left lower lobe was attempted in prone oblique position for tissue diagnosis. Local anaesthetic (lidocaine) was administered using a 25--gauge (1.5-inch) needle to anaesthetise the skin and subcutaneous tissue. This was followed by insertion of a 25-gauge (3.5-inch) Whitacre needle to anaesthetise deeper tissues and parietal pleura...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29427160/metformin-associated-lactic-acidosis-a-case-report
#3
Takehide Umeda, Taro Minami, Keith Bartolomei, Eleanor Summerhill
A 54-year-old woman with type 2 diabetes mellitus, hypertension, and peripheral vascular disease developed life-threatening lactic acidosis during treatment with metformin for type 2 diabetes. The woman received metformin at 1000 mg orally twice a day for type 2 diabetes. She presented to our emergency department with a 3-day history of severe watery diarrhea, nausea, and vomiting. Her grandson whom she cared for had gastroenteritis several days prior to the onset of her symptoms. She was confused and hypotensive with a blood pressure of 70/39 mmHg...
February 9, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29408228/initial-electrical-frequency-predicts-survival-and-neurological-outcome-in-out-of-hospital-cardiac-arrest-patients-with-pulseless-electrical-activity
#4
Christoph Weiser, Michael Poppe, Fritz Sterz, Harald Herkner, Christian Clodi, Christoph Schriefl, Alexandra Warenits, Mathias Vossen, Michael Schwameis, Alexander Nürnberger, Alexander Spiel
BACKGROUND: Outcome is generally poor in out of hospital cardiac arrests (OHCA) with initial non-shockable rhythms. Termination of resuscitation rules facilitate early prognostication at the scene to cease resuscitation attempts in futile situations and to proceed advanced life support in promising conditions. As pulseless electrical activity (PEA) is present as first rhythm in every 4th OHCA we were interested if the initial electrical frequency in PEA predicts survival. METHODS: All patients >18 years of age with non-traumatic OHCA and PEA as first rhythm between August 2013 and August 2015 from the Vienna Cardiac Arrest Registry were included in this retrospective observational study...
February 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29401183/cognitive-aids-do-not-prompt-initiation-of-cardiopulmonary-resuscitation-in-simulated-pediatric-cardiopulmonary-arrests
#5
Kristen Nelson McMillan, Michael A Rosen, Nicole A Shilkofski, Jamie Haggerty Bradshaw, Mary Saliski, Elizabeth A Hunt
INTRODUCTION: Although American Heart Association guidelines exist for proper management of cardiopulmonary arrest (CPA), in-hospital cardiopulmonary resuscitation (CPR) may be of poor quality and is not performed in all indicated situations. Cognitive aids have been created to assist in rapid, accurate recall of guidelines for pediatric CPA management. METHODS: Pediatric residents participated in individual mock codes for two years. Using a high-fidelity simulator, each resident participated in a standardized scenario that required management of both pulseless ventricular tachycardia and pulseless electrical activity...
February 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29364925/the-predictive-value-of-bedside-ultrasound-to-restore-spontaneous-circulation-in-patients-with-pulseless-electrical-activity-a-systematic-review-and-meta-analysis
#6
Chunshuang Wu, Zhongjun Zheng, Libing Jiang, Yuzhi Gao, Jiefeng Xu, Xiaohong Jin, Qijiang Chen, Mao Zhang
BACKGROUND: The prognosis of pulseless electrical activity is dismal. However, it is still challengable to decide when to terminate or continue resuscitation efforts. The aim of this study was to determine whether the use of bedside ultrasound (US) could predict the restoration of spontaneous circulation (ROSC) in patients with pulseless electrical activity (PEA) through the identification of cardiac activity. METHODS: This was a systematic review and meta-analysis of studies that used US to predict ROSC...
2018: PloS One
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#7
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
January 9, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29279412/association-between-prompt-defibrillation-and-epinephrine-treatment-with-long-term-survival-after-in-hospital-cardiac-arrest
#8
Krishna K Patel, John A Spertus, Yevgeniy Khariton, Yuanyuan Tang, Lesley H Curtis, Paul S Chan
Background -Prior studies have reported higher in-hospital survival with prompt defibrillation and epinephrine treatment in patients suffering in-hospital cardiac arrest (IHCA). Whether this survival benefit persists after discharge is unknown. Methods -We linked data from a national IHCA registry with Medicare files and identified 36,961 patients aged ≥65 years with an IHCA at 517 hospitals between 2000 and 2011. Patients with IHCA due to pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) were stratified by prompt (≤2 min) vs...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29220414/detection-of-spontaneous-pulse-using-the-acceleration-signals-acquired-from-cpr-feedback-sensor-in-a-porcine-model-of-cardiac-arrest
#9
Liang Wei, Gang Chen, Zhengfei Yang, Tao Yu, Weilun Quan, Yongqin Li
BACKGROUND: Reliable detection of return of spontaneous circulation with minimal interruptions of chest compressions is part of high-quality cardiopulmonary resuscitation (CPR) and routinely done by checking pulsation of carotid arteries. However, manual palpation was time-consuming and unreliable even if performed by expert clinicians. Therefore, automated accurate pulse detection with minimal interruptions of chest compression is highly desirable during cardiac arrest especially in out-of-hospital settings...
2017: PloS One
https://www.readbyqxmd.com/read/29191702/association-of-initial-recorded-rhythm-and-underlying-cardiac-disease-in-sudden-cardiac-arrest
#10
Janna P Kauppila, Antti Hantula, Marja-Leena Kortelainen, Lasse Pakanen, Juha Perkiömäki, Matti Martikainen, Heikki V Huikuri, M Juhani Junttila
BACKGROUND: Asystole (ASY) and pulseless electrical activity (PEA) are increasing and ventricular fibrillation (VF) or ventricular tachycardia (VT) declining as presenting rhythms of sudden cardiac arrest (SCA). Since there is limited information on possible differences in the etiology of underlying structural heart disease, we analyzed the clinical and/or autopsy findings of victims with ASY, PEA or VT/VF. METHODS: All SCA cases with recorded ASY, PEA or VT/VF occurring after onset of witnessed collapse were analyzed by the emergency personnel between the years 2007-2012 within the Oulu University Hospital area...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29177620/revisiting-traumatic-cardiac-arrest-should-cpr-be-initiated
#11
Katie L Konesky, Weidun Alan Guo
OBJECTIVES: Traumatic cardiac arrest (TCA) represents a unique problem, and poses difficult challenges in the care of trauma patients. Although the literature has suggested that attempted resuscitation from TCA in trauma is futile and consumptive of medical and human resources, studies have recently demonstrated that the outcome of TCA is comparable cardiac arrest secondary to non-traumatic events. The objective of this study was to determine the incidence, predictors, and outcomes following TCA...
November 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29173410/sudden-cardiac-death-in-ischemic-heart-disease-pathophysiology-and-risk-stratification
#12
REVIEW
Nabil El-Sherif, Mohamed Boutjdir, Gioia Turitto
Sudden cardiac death (SCD) accounts for approximately 360,000 deaths annually in the United States. Ischemic heart disease is the major cause of death in the general adult population. SCD can be due to arrhythmic or nonarrhythmic cardiac causes. Arrhythmic SCD may be caused by ventricular tachyarrhythmia or pulseless electrical activity/asystole. This article reviews the most recent pathophysiology and risk stratification strategies for SCD, emphasizing electrophysiologic surrogates of conduction disorder, dispersion of repolarization, and autonomic imbalance...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#13
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122647/an-automatic-system-for-the-comprehensive-retrospective-analysis-of-cardiac-rhythms-in-resuscitation-episodes
#14
Ali Bahrami Rad, Trygve Eftestøl, Unai Irusta, Jan Terje Kvaløy, Lars Wik, Jo Kramer-Johansen, Aggelos K Katsaggelos, Kjersti Engan
AIM: An automatic resuscitation rhythm annotator (ARA) would facilitate and enhance retrospective analysis of resuscitation data, contributing to a better understanding of the interplay between therapy and patient response. The objective of this study was to define, implement, and demonstrate an ARA architecture for complete resuscitation episodes, including chest compression pauses (CC-pauses) and chest compression intervals (CC-intervals). METHODS: We analyzed 126...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29102470/long-term-survival-trends-of-medicare-patients-after-in-hospital-cardiac-arrest-insights-from-get-with-the-guidelines-resuscitation%C3%A2
#15
Lauren E Thompson, Paul S Chan, Fengming Tang, Brahmajee K Nallamothu, Saket Girotra, Sarah M Perman, Somnath Bose, Stacie L Daugherty, Steven M Bradley
BACKGROUND: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. OBJECTIVE: To examine 1-year survival trends overall and by rhythm after IHCA. METHODS: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival...
February 2018: Resuscitation
https://www.readbyqxmd.com/read/29090256/pulseless-electrical-activity-during-general-anesthesia-induction-in-patients-with-amyotrophic-lateral-sclerosis
#16
Tae Min You, Seungoh Kim
Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia...
September 2017: Journal of dental anesthesia and pain medicine
https://www.readbyqxmd.com/read/29078850/pulmonary-embolism-in-transit-before-pulseless-electrical-activity-arrest
#17
Lance D McLeroy, David D Daly, Jeremy D Rier, Chitra Lal, Valerian L Fernandes
No abstract text is available yet for this article.
October 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29076453/-in-hospital-cardiac-arrest-in-a-69-year-old-woman-treated-with-extracorporeal-cardiopulmonary-resuscitation
#18
Ali Akkawi, Joachim Hoffmann Petersen, Lars Riber
A 69-year-old woman was admitted to the emergency unit due to respiratory distress. Initially the blood pressure was normal. However, it decreased concomitant with low saturation (70%), and it was decided to intubate her due to hypoxia. During intubation, she developed in-hospital cardiac arrest with pulseless electric activity as initial rhythm. Cardio pulmonary resuscitation was initiated, but sufficient spontaneous circulation was not obtained. We successfully initiated extracorporeal life support, and the patient survived with a good outcome...
October 23, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29068499/changes-in-paced-signals-may-predict-in-hospital-cardiac-arrest
#19
Mina Attin, Spencer Rosero, Jimmy Ding, Scot Nolan, Rebecca Tucker
BACKGROUND: An increasing number of patients with chronic illnesses have implanted cardiac rhythm devices such as pacemakers and implantable cardioverter-defibrillators (ICD). This study was conducted to identify potentially useful predictors of in-hospital cardiac arrest (I-HCA) within paced electrocardiogram (ECG) signals from cardiovascular patients with implanted medical devices. METHODS: In this retrospective study of 17 subjects, full-disclosure ECG traces prior to the time of documented I-HCA were analyzed to determine R-R intervals and QRS durations (QRSd)...
October 25, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29055890/utility-of-prehospital-electrocardiogram-characteristics-as-prognostic-markers-in-out-of-hospital-pulseless-electrical-activity-arrests
#20
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
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