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Cardiac arrest transport

Jonathan Elmer, Clifton W Callaway, Chung-Chou H Chang, Jonathan Madaras, Christian Martin-Gill, Philip Nawrocki, Kristen A C Seaman, Denisse Sequeira, Owen T Traynor, Arvind Venkat, Heather Walker, David J Wallace, Francis X Guyette
STUDY OBJECTIVE: It is unknown whether regionalization of postarrest care by interfacility transfer to cardiac arrest receiving centers reduces mortality. We seek to evaluate whether treatment at a cardiac arrest receiving center, whether by direct transport or early interfacility transfer, is independently associated with long-term outcome. METHODS: We performed a retrospective cohort study including adults resuscitated from out-of-hospital cardiac arrest in southwestern Pennsylvania and neighboring Ohio, West Virginia, and Maryland, which includes approximately 5...
July 4, 2018: Annals of Emergency Medicine
Mirosław Tarasiuk, Bogdan Kalicki, Adam Leoniuk, Weronika Krysztopowicz, Piotr Gałkin, Marzena Wojewódzka-Żelezniakowicz
The pulmonary embolism is caused by the sudden occlusion or narrowing of the pulmonary artery or its branches through the emboli and it is the third cause of death due to cardiovascular diseases. This disease is characterized by multiple complications, among others, the sudden cardiac arrest or stroke. The success in treatment of pulmonary embolism depends on the early disease diagnosis and a valid therapeutic procedure. The aim of this paper is to discuss the diagnostic and therapeutic procedure in pulmonary embolism, based on the case report of 65-year-old patient with high risk pulmonary embolism complicated with sudden cardiac arrest and stroke...
June 27, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Chen Ji, Tom Quinn, Lucia Gavalova, Ranjit Lall, Charlotte Scomparin, Jessica Horton, Charles D Deakin, Helen Pocock, Michael A Smyth, Nigel Rees, Samantha J Brace-McDonnell, Simon Gates, Gavin D Perkins
OBJECTIVES: There is considerable interest in reducing the cost of clinical trials. Linkage of trial data to administrative datasets and disease-specific registries may improve trial efficiency, but it has not been reported in resuscitation trials conducted in the UK. To assess the feasibility of using national administrative and clinical datasets to follow up patients transported to hospital following attempted resuscitation in a cluster randomised trial of a mechanical chest compression device in out-of-hospital cardiac arrest...
July 28, 2018: BMJ Open
Eric Mercier, Peter A Cameron, Karen Smith, Ben Beck
INTRODUCTION: Regionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients...
July 25, 2018: BMJ Open
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Piotr Ładziński, Aleksander Pawlak, Marcin Zieliński, Agata Dąbrowska, Aniela Artyńska, Mariusz Gezela, Paweł Sobczyński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region (Greater Poland). The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF) and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication...
July 25, 2018: Artificial Organs
Yi-Chuan Chen, Kai-Hsiang Wu, Kuang-Yu Hsiao, Ming-Szu Hung, Yi-Chen Lai, Yuan-Shun Chen, Chih-Yao Chang
BACKGROUND: Prognostic factors for the outcomes in traumatic cardiac arrest (TCA) patients transported to hospitals without prehospital return of spontaneous circulation (ROSC) remain uncertain. The aim of this study is to investigate factors associated with outcomes in TCA patients without prehospital ROSC. METHODS: We conducted a retrospective cohort study using a multi-institutional, 5-year database. Only TCA patients without prehospital ROSC were included. The primary outcome was ROSC in the emergency department (ED), and the secondary outcome was 30-day survival...
July 17, 2018: Injury
Mahyar Heydarpour, Julius Ejiofor, Michael Gilfeather, Gregory Stone, Josh Gorham, Christine E Seidman, Jon G Seidman, Maroun Yammine, Simon C Body, Sary F Aranki, Jochen D Muehlschlegel
BACKGROUND: During cardiac surgery with cardiopulmonary bypass, delivery of cardioplegia solution to achieve electromechanical cardiac quiescence is obligatory. The addition of lidocaine to cardioplegia has advantages, however, its consequences at a molecular level remain unclear. We performed whole-genome RNA sequencing of the human left ventricular (LV) myocardium to elucidate the differences between whole blood (WB) cardioplegia with and without addition of lidocaine (LC) on gene expression...
July 17, 2018: Annals of Thoracic Surgery
Morten Langfeldt Friberg, Leif Rognås
OBJECTIVES: The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective was to describe these triage decisions in more detail with regard to the most common diagnoses, incidence of direct referral sorted by the prehospital critical care team (PHCCT) and the destination hospital. DESIGN: Retrospective descriptive study...
July 18, 2018: BMJ Open
Keith J Ruskin, Eduard M Ricaurte, Paulo M Alves
Although cardiac arrest during airline flights is relatively uncommon, the unusual setting, limited resources, and the variability of the skills in medical volunteers present unique challenges. Survival in patients who suffer a witnessed arrest with a shockable rhythm who are treated promptly has improved since the advent of widely available automated external defibrillators (AEDs). In general, the chances of survival from an out-of-hospital cardiac arrest (OHCA) are greater when ventricular fibrillation (VF) is seen as the initial rhythm or if there is return of spontaneous circulation (ROSC)...
August 1, 2018: Aerospace Medicine and Human Performance
John P Buchweitz, Douglas Mader, Andreas F Lehner
A case of canine intoxication and fatality with the pyrethroid insecticide bifenthrin is described. A 5-year-old female spayed Pit Bull Terrier was off leash and unsupervised at home for 15-20 min prior to discovery by her owner. The patient was in lateral recumbency, having what the owner described as a seizure. The patient was transported to an emergency veterinary hospital where she presented with tachycardia, tachypnea and intractable tremors/seizures. Despite aggressive medical intervention, the patient went into respiratory and cardiac arrest and died at 28 h after presentation...
July 11, 2018: Journal of Analytical Toxicology
Tetsuhisa Kitamura, Taku Iwami, Takahiro Atsumi, Tomoyuki Endo, Tomoo Kanna, Yasuhiro Kuroda, Atsushi Sakurai, Osamu Tasaki, Yoshio Tahara, Ryosuke Tsuruta, Jun Tomio, Kazuyuki Nakata, Sho Nachi, Mamoru Hase, Mineji Hayakawa, Takahiro Hiruma, Kenichi Hiasa, Takashi Muguruma, Takao Yano, Takeshi Shimazu, Naoto Morimura
Aim: To describe the registry design of the Japanese Association for Acute Medicine - out-of-hospital cardiac arrest (JAAM-OHCA) Registry as well as its profile on hospital information, patient and emergency medical service characteristics, and in-hospital procedures and outcomes among patients with OHCA who were transported to the participating institutions. Methods: The special committee aiming to improve the survival after OHCA by providing evidence-based therapeutic strategies and emergency medical systems from the JAAM has launched a multicenter, prospective registry that enrolled OHCA patients who were transported to critical care medical centers or hospitals with an emergency care department...
July 2018: Acute Medicine & Surgery
Ljiljana S Sulovic, Aleksandar P Pavlovic, Jovan B Zivkovic, Zorica N Zivkovic, Snezana S Filipovic-Danic, Slađana V Trpkovic
Case Report: The case of a drowning teenager is described involving application of cardiopulmonary resuscitation (CPR) by an untrained rescuer in the field and fast transport to a hospital enabling a positive resuscitation outcome despite an underorganized emergency medical service in a rural area. In our case hypoxia led to extended functional disorders of the cardiovascular system, which fully recovered after adequate therapy. Conclusion: Knowledge about BLS measures by ordinary citizens, together with continuous education of health professionals concerning modern techniques of CPR, is crucial for increasing the number of patients surviving after cardiac arrest...
2018: Case Reports in Emergency Medicine
Alexandre Kottmann, Pierre-Nicolas Carron, Lorenz Theiler, Roland Albrecht, Mario Tissi, Mathieu Pasquier
BACKGROUND: Avalanche rescues mostly rely on helicopter emergency medical services (HEMS) and include technical rescue and complex medical situations under difficult conditions. The adequacy of avalanche victim management has been shown to be unexpectedly low, suggesting the need for quality improvement. We analyse the technical rescue and medical competency requirements of HEMS crewmembers for avalanche rescue missions, as well as their clinical exposure. The study aims to identify areas that should be the focus of future quality improvement efforts...
July 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
E J Yates, S Schmidbauer, A M Smyth, M Ward, S Dorrian, A N Siriwardena, H Friberg, G D Perkins
INTRODUCTION: Termination of resuscitation guidelines for out-of-hospital cardiac arrest can identify patients in whom continuing resuscitation has little chance of success. This study examined the outcomes of patients transferred to hospital with ongoing CPR. It assessed outcomes for those who would have met the universal prehospital termination of resuscitation criteria (no shocks administered, unwitnessed by emergency medical services, no return of spontaneous circulation). METHODS: A retrospective cohort study of consecutive adult patients who were transported to hospital with ongoing CPR was conducted at three hospitals in the West Midlands, UK between September 2016 and November 2017...
June 27, 2018: Resuscitation
Yifeng Peng, John Kheir, Brian Polizzotti
Intravascular oxygen delivery holds great potential to treat numerous hypoxic conditions and emergencies, including pulmonary disorders, hypoxic tumors, hemorrhagic shock, stroke, cardiac arrest and so on. Tremendous effort has been made in the past to find material solutions for the development of intravenous oxygen carriers and have ranged from blood substitutes to microbubbles with limited success. This paper highlights previous and recent progress in perfluorocarbon-emulsions and microbubbles as intravenous gas carriers, including concerns over their long-term stability, in vivo safety profiles, and oxygen transport efficacy...
June 27, 2018: Chemistry: a European Journal
Robert H Thiele, Keita Ikeda, Hari P Osuru, Zhiyi Zuo
BACKGROUND: Cytochrome aa3, the terminal component of the electron transport chain, absorbs near-infrared radiation (NIR) differentially depending on its oxidation state (Cytox), which can in theory be measured using near-infrared spectroscopy (NIRS) by relating light absorption at specific wavelengths to chromophore concentrations. Some NIRS algorithms use discrete wavelengths, while others analyze a band of NIR (broadband NIRS). The purpose of this study was to test the ability of discrete wavelength and broadband algorithms to measure changes in Cytox (primary outcome), and to determine whether or not a discreet wavelength NIRS algorithm could perform similarly to a broadband NIRS algorithm for the measurement of Cytox in a staged hypoxia-cyanide model (hypoxia and cyanide have oppositional effects on tissue saturation, but both cause cytochrome reduction)...
June 14, 2018: Anesthesia and Analgesia
Maximilian Scharonow, Christian Weilbach
BACKGROUND: In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated...
June 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Kurtis Poole, Keith Couper, Michael A Smyth, Joyce Yeung, Gavin D Perkins
In cardiac arrest, high quality cardiopulmonary resuscitation (CPR) is a key determinant of patient survival. However, delivery of effective chest compressions is often inconsistent, subject to fatigue and practically challenging.Mechanical CPR devices provide an automated way to deliver high-quality CPR. However, large randomised controlled trials of the routine use of mechanical devices in the out-of-hospital setting have found no evidence of improved patient outcome in patients treated with mechanical CPR, compared with manual CPR...
May 29, 2018: Critical Care: the Official Journal of the Critical Care Forum
P Setälä, H Hellevuo, H Huhtala, A Kämäräinen, J Tirkkonen, S Hoppu
BACKGROUND: We aimed to determine the incidence of and associated risk factors for cardiopulmonary resuscitation (CPR)-related injuries in non-survivors of out-of-hospital cardiac arrests (OHCAs) in an emergency medical service (EMS) system in which all CPR procedures are performed on scene and patients are not routinely transported to the hospital with ongoing CPR. MATERIAL AND METHODS: We conducted this prospective observational study between 1 June 2013, and 31 May 2014...
May 24, 2018: Acta Anaesthesiologica Scandinavica
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
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