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Cardiac arrest transport

Hiromichi Ohsaka, Youichi Yanagawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Shunsuke Madokoro, Akihiko Kondo, Kouhei Ishikawa, Kazuhiko Omori
OBJECTIVE: In Japan, the main helicopters that transport patients are physician-staffed helicopters (known as doctor helicopters [DHs]) and firefighter/rescue helicopters (F/RHs). We report the collaboration between F/RHs and DHs in eastern Shizuoka Prefecture. METHODS: We retrospectively investigated all of the patients who were transported by F/RHs in Shizuoka Prefecture between January 2015 and April 2018. RESULTS: Nine cases were defined as subjects...
September 2018: Air Medical Journal
Mark Froats, Andrew Reed, Richard Dionne, Justin Maloney, Susan Duncan, Rob Burns, Julie Sinclair, Michael Austin
BACKGROUND: Most patients transferred from a non-percutaneous coronary intervention (PCI) facility for primary PCI do not meet target reperfusion times. Direct transportation of patients with ST-elevation myocardial infarction (STEMI) from the scene by advanced life support (ALS) paramedics has been shown to improve reperfusion times and outcomes. OBJECTIVE: The aim of this study was to determine whether it is safe to bypass the closest hospital and transport by basic life support (BLS) provider to a PCI facility...
October 9, 2018: Journal of Emergency Medicine
Kylie Dyson, Dion Stub, Stephen Bernard, Karen Smith
High-quality cardiopulmonary resuscitation, in particular chest compressions, is a key aspect of out-of-hospital cardiac arrest (OHCA) resuscitation. Manual chest compressions remain the standard of care; however, the extrication and transport of patients with OHCA undermine the quality of manual chest compressions and risk the safety of paramedics. Therefore, in circumstances whereby high-quality manual chest compressions are difficult or unsafe, paramedics should consider using a mechanical device. By combining high-quality manual chest compressions and judicious application of mechanical chest compressions, emergency medical service agencies can optimize paramedic safety and patient outcomes...
August 2018: Cardiology Clinics
J Nas, J Thannhauser, J J Herrmann, K van der Wulp, P M van Grunsven, N van Royen, M J de Boer, J L Bonnes, M A Brouwer
PURPOSE: Out-of-hospital cardiac arrests (OHCAs) are a major healthcare problem. Over the years, several initiatives have contributed to more lay volunteers providing cardiopulmonary resuscitation (CPR) and increased use of automated external defibrillators (AEDs) in the Netherlands. As part of a quality and outcomes program, we registered bystander CPR, AED use and outcome in the Nijmegen area. METHODS: Prospective resuscitation registry with a study cohort of non-traumatic OHCA cases from 2013-2016 and historical controls from 2008-2011...
October 2, 2018: Netherlands Heart Journal
Kyung Hune Cho, Jong-Hak Park, Sung Woo Moon, Seong-Keun Yun, Jin-Young Kim
OBJECTIVE: In South Korea, the Gyeonggi Fire Services introduced a multi-tiered dispatch system for out-of-hospital cardiac arrest (OHCA) cases in July 2015. In this study, we investigated whether the multi-tiered dispatch system improved the pre-hospital return of the spontaneous circulation (ROSC) rate. METHODS: All non-traumatic adult OHCAs treated and transported by the 119 emergency medical system from July 2015 to December 2015 were included in the study. Demographic and pre-hospital Utstein element-data were collected from the emergency medical system OHCA database...
September 2018: Clinical and Experimental Emergency Medicine
Emilie Gregers, Jesper Kjærgaard, Freddy Lippert, Jakob H Thomsen, Lars Køber, Michael Wanscher, Christian Hassager, Helle Søholm
BACKGROUND: The prognosis in refractory out-of-hospital cardiac arrest (OHCA) with ongoing cardiopulmonary resuscitation (CPR) at hospital arrival is often considered dismal. The use of extracorporeal cardiopulmonary resuscitation (eCPR) for perfusion enhancement during resuscitation has shown variable results. We aimed to investigate outcome in refractory OHCA patients managed conservatively without use of eCPR. METHODS: We included consecutive OHCA patients with refractory arrest or prehospital return of spontaneous circulation (ROSC) in the Copenhagen area in 2002-2011...
September 29, 2018: Critical Care: the Official Journal of the Critical Care Forum
R M Carrillo-Larco, M Moscoso-Porras, A Taype-Rondan, A Ruiz-Alejos, A Bernabe-Ortiz
Background: Unmanned aircraft vehicles (UAVs) have had a rapid escalation in manageability and affordability, which can be exploited in healthcare. We conducted a systematic review examining the use of drones for health-related purposes. Methods: A search was conducted in Medline, Embase, Global Health, Scopus, CINAHL and SciELO. Experimental studies were selected if the population included human subjects, the intervention was the use of UAVs and there was a health-related outcome...
2018: Global health, epidemiology and genomics
James Vassallo, Melanie Webster, Edward B G Barnard, Mark D Lyttle, Jason E Smith
OBJECTIVE: To describe the epidemiology and aetiology of paediatric traumatic cardiac arrest (TCA) in England and Wales. DESIGN: Population-based analysis of the UK Trauma Audit and Research Network (TARN) database. PATIENTS AND SETTING: All paediatric and adolescent patients with TCA recorded on the TARN database for a 10-year period (2006-2015). MEASURES: Patient demographics, Injury Severity Score (ISS), location of TCA ('prehospital only', 'in-hospital only' or 'both'), interventions performed and outcome...
September 27, 2018: Archives of Disease in Childhood
Jay S Shavadia, Matthew T Roe, Anita Y Chen, Joseph Lucas, Alexander C Fanaroff, Ajar Kochar, Christopher B Fordyce, James G Jollis, Jacqueline Tamis-Holland, Timothy D Henry, Akshay Bagai, Michael C Kontos, Christopher B Granger, Tracy Y Wang
OBJECTIVES: The aim of this study was to describe the prevalence of pre-hospital cardiac catheterization laboratory activation and its association with reperfusion timeliness and in-hospital mortality. BACKGROUND: For patients with ST-segment elevation myocardial infarction diagnosed in the field, catheterization laboratory pre-activation may lead to more timely reperfusion and improved outcomes. METHODS: A total of 27,840 patients with ST-segment elevation myocardial infarction transported via emergency medical services to 744 percutaneous coronary intervention-capable hospitals in the ACTION Registry from January 2015 to March 2017 were evaluated, excluding patients with cardiac arrest or requiring pre-percutaneous coronary intervention intubation...
September 24, 2018: JACC. Cardiovascular Interventions
Christopher Berry, Douglas Kupas, Mark Olaf, Anne Knorr, Andrea Berger
BACKGROUND: The approach to managing out-of-hospital cardiac arrest (OOHCA) has generally involved either minimal on-scene resuscitation to reduce time to arrival at hospital or extended care at the scene to increase the chance of return of spontaneous circulation (ROSC) before transport. This study compared patient outcomes across EMS agencies with respect to the duration of on-scene time. We hypothesized that EMS agencies with greater average time on-scene would have more favorable outcomes...
September 15, 2018: Prehospital Emergency Care
Eli Jaffe, Ziv Dadon, Evan Avraham Alpert
Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Bystanders and organized volunteer first responders have often helped in extricating the victims, stopping the bleeding, and aiding in the evacuation of the victims...
September 17, 2018: Prehospital and Disaster Medicine
Michael Wasko, Paula A Witt-Enderby, Christopher K Surratt
The West African iboga plant has been used for centuries by the Bwiti and Mbiri tribes to induce hallucinations during religious ceremonies. Ibogaine, the principal alkaloid responsible for iboga's psychedelic properties, was isolated and sold as an antidepressant in France for decades before its adverse effects precipitated its removal from the market. An ibogaine resurgence in the 1960s was driven by U.S. heroin addicts who claimed that ibogaine cured their opiate addictions. Behavioral pharmacologic studies in animal models provided evidence that ibogaine could blunt self-administration of not only opiates but cocaine, amphetamines, and nicotine...
September 14, 2018: ACS Chemical Neuroscience
Peter J Holmberg, Grace Arteaga, Brenda M Schiltz, James Homme
Selective serotonin reuptake inhibitors are a commonly used and often effective class of medications in the treatment of mood disorders such as anxiety and depression. Sertraline (1S,4S-N-methyl-4-[3,4-dichlorophenyl]-1,2,3,4-tetrahydro-1-naphthylamine [Zoloft; Pfizer, New York City, NY]) is a frequently used selective serotonin reuptake inhibitor that has shown efficacy in children, adolescents, and adults. We report the case of a 13-year-old boy with sertraline-induced rhabdomyolysis and renal failure, trismus, and cardiopulmonary arrest...
October 2018: Pediatrics
Jian-Sheng Feng, Bing-Heng Lou, Yu Chen
Objective To compare the clinical outcomes of continuous chest compressions (CCP) or interrupt chest compression (ICP) for the cardiac arrest patients. Methods Totally 114 adult patients with out-of-hospital non-trauma-related cardiac arrest that needed cardiopulmonary resuscitation (CPR) in Quzhou People's Hospital from January 2014 to January 2017 were enrolled in this study. Patients who divided into CCP group (n=70) and ICP group (n=44) according to the maneuvers. The clinical data of these two groups were collected and compared...
August 30, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Atsushi Kawaguchi, L Duncan Saunders, Yutaka Yasui, Allan DeCaen
BACKGROUND AND OBJECTIVES: The need to centralize patients for specialty care in the setting of regionalization may delay access to specialist services and compromise outcomes, particularly in a large geographic area. The aim of this study was to explore the effects of interhospital transferring of children requiring intensive care in a Canadian regionalization model. METHODS: A retrospective cohort design with a matched pair analysis was adopted to compare the outcomes in children younger than 17 years admitted to a pediatric intensive care unit (PICU) of a Canadian children's hospital by a specialized transport team (pediatric critical care transported [PCCT] group) and those children admitted directly to PICU from its pediatric emergency department (PED group)...
September 6, 2018: Journal of Intensive Care Medicine
Jonathan Tam, Angela Hong, Peter M Naranjo, Tai Yin, Koichiro Shinozaki, Joshua W Lampe, Lance B Becker, Junhwan Kim
Ischemic brain damage is the major cause of mortality in cardiac arrest (CA). However, the molecular mechanism responsible for brain damage is not well understood. We previously found that mitochondrial state-3 respiration, which had been decreased following CA, was recovered in the kidney and liver, but not in the brain following cardiopulmonary bypass (CPB) resuscitation. Examination of mitochondria from these tissues may shed light on why the brain is the most vulnerable. In this study, adult male Sprague-Dawley rats were subjected to asphyxia-induced CA for 30 min or 30 min followed by 60 min CPB resuscitation...
November 2018: Neurochemistry International
Kui Xu, Michelle A Puchowicz, Joseph C LaManna
Transient global brain ischemia, induced by cardiac arrest and resuscitation, results in reperfusion injury leading to delayed selective neuronal cell loss and post-resuscitation mortality. This study determined the effects of post-resuscitation hypotension and hypothermia on long-term survival following cardiac arrest and resuscitation. The capillary density was also determined. Based on the mean arterial blood pressure (MABP) at 1 h of recovery, the normotension group (MABP 80-120 mmHg) and hypotension group (MABP <80 mmHg) were defined...
2018: Advances in Experimental Medicine and Biology
Jason A Bartos, Kathleen Carlson, Claire Carlson, Ganesh Raveendran, Ranjit John, Tom P Aufderheide, Demetris Yannopoulos
BACKGROUND: Resuscitation of refractory out-of-hospital ventricular fibrillation/ventricular tachycardia (VF/VT) cardiac arrest using extracorporeal membrane oxygenation (ECMO) establishes a complex patient population. We aimed to describe the critical care strategies and outcomes in this population. METHODS: Between December 1, 2015 and January 1, 2018, 100 consecutive adult patients with refractory VF/VT out-of-hospital cardiac arrest and ongoing CPR were transported to the cardiac catheterization laboratory...
November 2018: Resuscitation
Masashi Takahashi, Yusuke Kondo, Keitaro Senoo, Yoshihide Fujimoto, Yoshio Kobayashi
BACKGROUND: Studies involving long-term follow-up analysis of patients who have survived cardiopulmonary arrest (CPA) due to acute myocardial infarction (AMI) are rare. This study aimed to determine the incidence and prognosis of CPA in patients with AMI. METHODS: We retrospectively analyzed our database of AMI patients examined between January 2012 and September 2017. The characteristics of those who experienced CPA due to MI were compared to those who did not (CPA group and non-CPA group)...
October 2018: Journal of Cardiology
Toshinobu Yamagishi, Takahiro Tanabe, Hiroshi Fujita, Kazuki Miyazaki, Takahiro Yukawa, Kazuhiro Sugiyama, Yuichi Hamabe
BACKGROUND: Patients with left ventricular outflow tract obstruction who do not exhibit a dynamic pressure gradient at rest, experience pressure gradient increases of ≥ 30 mmHg only during specific situations; this is called latent left ventricular outflow tract obstruction. It is provoked by increased cardiac contraction and preload and afterload depletion. There are a few reports of patients with it developing cardiac arrest. We present a case of latent left ventricular outflow tract obstruction in which the patient with a sigmoid septum experienced refractory pulseless electrical activity due to conventional advanced cardiac life support...
August 20, 2018: Journal of Medical Case Reports
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