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https://www.readbyqxmd.com/read/28920131/reversible-causes-in-cardiovascular-collapse-at-the-emergency-department-using-ultrasonography-revive-us
#1
Mui Teng Chua, Gene Wh Chan, Win Sen Kuan
INTRODUCTION: Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality...
August 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28916478/a-retrospective-study-of-pulseless-electrical-activity-bedside-ultrasound-identifies-interventions-during-resuscitation-associated-with-improved-survival-to-hospital-admission-a-reason-study
#2
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel Brown, Terrell Caffery, Emily Douglass, Jacqueline Fraser, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Fernando Lopez, Elke Platz, Michelle Mendoza, Hal Minnigan, Christopher Moore, Joseph Novik, Louise Rang, Will Scruggs, Christopher Raio
OBJECTIVE: Our objective was to determine whether organized or disorganized cardiac activity is associated with increased survival in patients who present in pulseless electrical activity (PEA) treated with either 1) standard advanced cardiac life support (ACLS) medications or 2) other interventions. METHODS: This was a secondary analysis of a prospective, multi-center observational study utilizing ultrasound in out-of-hospital or inemergency department PEA arrest...
September 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28887695/a-nirs-death-experience-a-reduction-in-cortical-oxygenation-by-time-resolved-near-infrared-spectroscopy-preceding-cardiac-arrest
#3
C Lanks, C B Kim, H B Rossiter
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS...
September 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28885561/acute-and-late-toxicities-of-concurrent-chemoradiotherapy-for-locally-advanced-non-small-cell-lung-cancer
#4
REVIEW
Vivek Verma, Charles B 2nd Simone, Maria Werner-Wasik
For patients with unresectable locally-advanced non-small cell lung cancer (LA-NSCLC), concurrent chemoradiotherapy improves overall survival as compared to sequential chemotherapy and radiation therapy, but is associated with higher rates of toxicities. Acute, clinically significant esophagitis or pneumonitis can occur in one in five patients. The risks of esophagitis and pneumonitis can impact the decision to deliver concurrent therapy and limit the total dose of radiation therapy that is delivered. Hematologic toxicities and emesis are common toxicities from systemic therapies for LA-NSCLC and can result in delaying chemotherapy dosing or chemotherapy dose reductions...
September 8, 2017: Cancers
https://www.readbyqxmd.com/read/28885062/out-of-hospital-cardiac-arrest-always-coronary-angiography
#5
Andrea Rognoni, Chiara Cavallino, Marco Giovanni Mennuni, Lucia Barbieri, Roberta Rosso, Francesco Rametta, Federico Nardi, Alessandro Lupi, Angelo Sante Bongo
Out-of-hospital cardiac arrest (OHCA) remains one of the principle challenges in the setting of critical care medicine and emergency cardiology. Areas covered: Long-term survival rates even after successful resuscitation are variable but increasing in the recent years; due to the improvement of base and advanced cardiac life support techniques an increasing number of resuscitated patients are admitted to the hospital. Recent data suggested that patients surviving to hospital discharge after OHCA presented long-term outcome similar to patients with ST-elevation myocardial infarction...
September 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28864072/improvements-in-the-quality-of-advanced-life-support-and-patient-outcome-after-implementation-of-a-standardized-real-life-post-resuscitation-feedback-system
#6
Pia Hubner, Elisabeth Lobmeyr, Christian Wallmüller, Michael Poppe, Philip Datler, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Andreas Zajicek, Anton Laggner, Fritz Sterz, Patrick Sulzgruber
BACKGROUND: Educational aspects in the training of advanced life support (ALS) represent a key role in critical care management of patients with out-of-hospital cardiac arrest (OHCA) and received special attention in guidelines of various international societies. While a positive association of feedback on ALS performance in training conditions is well established, data on the impact of a real-life post-resuscitation feedback on both ALS quality and outcome remain scarce and inconclusive...
August 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28863949/impact-of-rapid-response-car-system-on-extracorporeal-life-support-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#7
Ryota Sato, Akira Kuriyama, Michitaka Nasu, Shinnji Gima, Wataru Iwanaga, Tadaaki Takada, Yusuke Kitahara, Hideto Fukui, Terutake Yonemori, Masaharu Yagi
INTRODUCTION: Extracorporeal life support (ECLS) has been reported to be more effective than conventional cardiopulmonary resuscitation (CPR). In ECLS, a shorter time from arrival to implantation of extracorporeal membrane oxygenation (ECMO; door-to-ECMO) time was predicted to be associated with better survival rates. This study aimed to examine the impact of the physician-based emergency medical services (P-EMS) using a rapid response car (RRC) on door-to-ECMO time in patients with out-of-hospital cardiac arrest (OHCA)...
August 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28859792/how-medicine-has-changed-the-end-of-life-for-patients-with-cardiovascular-disease
#8
REVIEW
Haider J Warraich, Adrian F Hernandez, Larry A Allen
Advances in medicine have changed how patients experience the end of life. With longer life spans, there has also been an increase in years lived with disability. The clustering of illnesses in the last years of life is particularly pronounced in patients with cardiovascular disease. At the end of life, patients with cardiovascular disease are more symptomatic, less likely to die at home, and less likely to receive high-quality palliative care. Social determinants have created widening disparities in end-of-life care...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28857647/ems-dispatches-during-hurricanes-irene-and-sandy-in-new-jersey
#9
Joshua Bucher, Jonathan McCoy, Colleen Donovan, Snehal Patel, Pamela Ohman-Strickland, Asa Dewan
BACKGROUND: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. OBJECTIVES: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. METHODS: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28836556/epinephrine-in-out-of-hospital-cardiac-arrest-helpful-or-harmful
#10
REVIEW
Huan Shao, Chun-Sheng Li
OBJECTIVE: Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest. The evidence for the use of adrenaline in out-of-hospital cardiac arrest (OHCA) and in-hospital resuscitation is inconclusive. We conducted a systematic review on the clinical efficacy of adrenaline in adult OHCA patients to evaluate whether epinephrine provides any overall benefit for patients. DATA SOURCES: The EMBASE and PubMed databases were searched with the key words "epinephrine," "cardiac arrest," and variations of these terms...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28827198/survival-of-cardiac-arrest-patients-on-ski-slopes-a-10-year-analysis-of-the-northern-french-alps-emergency-network
#11
Damien Viglino, Maxime Maignan, Arnaud Michalon, Julien Turk, Sarah K Buse, Marc Blancher, Tom P Aufderheide, Loïc Belle, Dominique Savary, François-Xavier Ageron, Guillaume Debaty
AIM: Intense physical activity, cold and altitude make mountain sports a cause of increased risk of out-of-hospital cardiac arrest (OHCA). The difficulties of pre-hospital management related to this challenging environment could be mitigated by the presence of ski-patrollers in ski areas and use of helicopters for medical rescue. We assess whether this particular situation positively impacts the chain of survival compared to the general population. METHODS: Analysis of prospectively collected data from the cardiac arrest registry of the Northern French Alps Emergency Network (RENAU) from 2004 to 2014...
August 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28817508/end-tidal-co2-guided-chest-compression-delivery-improves-survival-in-a-neonatal-asphyxial-cardiac-arrest-model
#12
Justin T Hamrick, Jennifer L Hamrick, Utpal Bhalala, Jillian S Armstrong, Jeong-Hoo Lee, Ewa Kulikowicz, Jennifer K Lee, Sapna R Kudchadkar, Raymond C Koehler, Elizabeth A Hunt, Donald H Shaffner
OBJECTIVES: To determine whether end-tidal CO2-guided chest compression delivery improves survival over standard cardiopulmonary resuscitation after prolonged asphyxial arrest. DESIGN: Preclinical randomized controlled study. SETTING: University animal research laboratory. SUBJECTS: 1-2-week-old swine. INTERVENTIONS: After undergoing a 20-minute asphyxial arrest, animals received either standard or end-tidal CO2-guided cardiopulmonary resuscitation...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28807986/a-turbine-driven-ventilator-improves-adherence-to-advanced-cardiac-life-support-guidelines-during-a-cardiopulmonary-resuscitation-simulation
#13
Scott G Allen, Lara Brewer, Erik S Gillis, Nathan L Pace, Derek J Sakata, Joseph A Orr
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8 -10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28767532/cardiac-arrest-secondary-to-lightning-strike-case-report-and-review-of-the-literature
#14
Elena L Rotariu, Mioara D Manole
Lightning strike injuries, although less common than electrical injuries, have a higher morbidity rate because of critical alterations of the circulatory system, respiratory system, and central nervous system. Most lightning-related deaths occur immediately after injury because of arrhythmia or respiratory failure. We describe the case of a pediatric patient who experienced cardiorespiratory arrest secondary to a lightning strike, where the Advanced Cardiac Life Support and Basic Life Support chain of survival was well executed, leading to return of spontaneous circulation and intact neurological survival...
August 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28761704/cpr-performance-in-the-presence-of-audiovisual-feedback-or-football-shoulder-pads
#15
Shota Tanaka, Wayne Rodrigues, Susan Sotir, Ryo Sagisaka, Hideharu Tanaka
OBJECTIVE: The initiation of cardiopulmonary resuscitation (CPR) can be complicated by the use of protective equipment in contact sports, and the rate of success in resuscitating the patient depends on the time from incident to start of CPR. The aim of our study was to see if (1) previous training, (2) the presence of audiovisual feedback and (3) the presence of football shoulder pads (FSP) affected the quality of chest compressions. METHODS: Six basic life support certified athletic training students (BLS-ATS), six basic life support certified emergency medical service personnel (BLS-EMS) and six advanced cardiac life support certified emergency medical service personnel (ACLS-EMS) participated in a crossover manikin study...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/28751839/the-future-of-telemedicine-for-the-management-of-heart-failure-patients-a-consensus-document-of-the-italian-association-of-hospital-cardiologists-a-n-m-c-o-the-italian-society-of-cardiology-s-i-c-and-the-italian-society-for-telemedicine-and-ehealth-digital
#16
Andrea Di Lenarda, Giancarlo Casolo, Michele Massimo Gulizia, Nadia Aspromonte, Simonetta Scalvini, Andrea Mortara, Gianfranco Alunni, Renato Pietro Ricci, Roberto Mantovan, Giancarmine Russo, Gian Franco Gensini, Francesco Romeo
Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28741005/the-pan-asian-resuscitation-outcomes-study-paros-clinical-research-network-what-where-why-and-how
#17
Nausheen Edwin Doctor, Nur Shahidah Binte Ahmad, Pin Pin Pek, Susan Yap, Marcus Eng Hock Ong
Out-of-hospital cardiac arrest (OHCA) is a global health concern with an incidence rate of 50-60 per 100,000 person-years. To improve OHCA survival rates, several cardiac arrest registries have been set up in North America and Europe, such as the Resuscitation Outcomes Consortium, Cardiac Arrest Registry to Enhance Survival, Ontario Prehospital Advanced Life Support and European Registry of Cardiac Arrest. In Asia, however, there was previously no concerted effort in prehospital emergency care research owing to differences in prehospital emergency medical services systems, data collection methods and outcome reporting between countries...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741002/extracorporeal-membrane-oxygenation-in-cardiac-arrest
#18
Boon Kiat Kenneth Tan
The survival of cardiac arrest patients is dependent on the efficient and timely application of the chain of survival. This includes early identification of cardiac arrest and activation of the emergency response system, high-quality cardiopulmonary resuscitation (CPR), rapid defibrillation, basic and advanced medical services, and advanced life support and post-cardiac arrest care. However, some patients may be refractory to these measures. Extracorporeal membrane oxygenation CPR (ECPR), otherwise known as extracorporeal life support, offers an alternative to such refractory cardiac arrest cases...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740999/advanced-cardiac-life-support-2016-singapore-guidelines
#19
Chi Keong Ching, Siew Hon Benjamin Leong, Siang Jin Terrance Chua, Swee Han Lim, Kenneth Heng, Sohil Pothiawala, Venkataraman Anantharaman
The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28698191/manual-versus-semiautomatic-rhythm-analysis-and-defibrillation-for-out-of-hospital-cardiac-arrest
#20
Ziad Nehme, Emily Andrew, Resmi Nair, Stephen Bernard, Karen Smith
BACKGROUND: Although manual and semiautomatic external defibrillation (SAED) are commonly used in the management of out-of-hospital cardiac arrest, the optimal strategy is not known. We hypothesized that SAED would reduce the time to first shock and lead to higher rates of cardioversion and survival compared with a manual strategy. METHODS AND RESULTS: Between July 2005 and June 2015, we included adult out-of-hospital cardiac arrest of presumed cardiac pathogenesis...
July 2017: Circulation. Cardiovascular Quality and Outcomes
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