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https://www.readbyqxmd.com/read/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#1
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29021273/improvement-in-care-and-outcomes-for-emergency-medical-service-transported-patients-with-st-elevation-myocardial-infarction-stemi-with-and-without-prehospital-cardiac-arrest-a-mission-lifeline-stemi-accelerator-study
#2
Kristian Kragholm, Di Lu, Karen Chiswell, Hussein R Al-Khalidi, Mayme L Roettig, Matthew Roe, James Jollis, Christopher B Granger
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) with out-of-hospital cardiac arrest (OHCA) may benefit from direct transport to a percutaneous cardiac intervention (PCI) hospital but have previously been less likely to bypass local non-PCI hospitals to go to a PCI center. METHODS AND RESULTS: We reported time trends in emergency medical service transport and care of patients with STEMI with and without OHCA included from 171 PCI-capable hospitals in 16 US regions with participation in the Mission: Lifeline STEMI Accelerator program between July 1, 2012, and March 31, 2014...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29017658/-effect-of-a-stabilization-device-for-maintaining-the-balance-of-a-cpr-performer-during-ambulance-transportation-on-quality-of-cpr-in-out-of-hospital-cardiac-arrest-a-prospective-randomized-controlled-trial
#3
Jinping Guo, Shunyi Feng, Bo Wang, Shen Nie, Yong Li
OBJECTIVE: To investigate the effect of a stabilization device for maintaining the balance of a cardiopulmonary resuscitation (CPR) performer during ambulance transportation on quality of CPR in out-of-hospital cardiac arrest (OHCA). METHODS: A prospective randomized controlled trial was performed. 167 OHCA patients with cardiac arrest (CA) time < 10 minutes admitted to Cangzhou Central Hospital from October 2014 to January 2017 were enrolled, and divided into armed stabilization device group (n = 86) and unarmed stabilization device group (n = 81) by random number table...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29017646/-pre-hospital-therapeutic-hypothermia-for-survival-and-neuro-protection-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Yan Zhuang, Linfeng Dai, Mingqi Cheng, Haidong Zhang, Ning Chang
OBJECTIVE: To assess the effectiveness of pre-hospital therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) for survival and neuro-protection. METHODS: Databases such as Medline, ScienceDirect, Embase, Highwire, Cochrane Library, CNKI and Wanfang digital database were searched from January 2000 to March 2017 to retrieve randomized controlled trials (RCTs) on pre-hospital therapeutic hypothermia after OHCA. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29017644/-analysis-of-out-of-hospital-emergency-treatment-for-ventricular-fibrillation-between-2013-and-2016-in-shanghai
#5
Xingxiang Li, Feiyue Teng, Ping Xu, Minghua Li, Rongjiao Liu, Ping Fang, Jiawen Hu
OBJECTIVE: To investigate the epidemiological features of out-of-hospital patients with ventricular fibrillation (VF) in Shanghai and to analysis factors associated with outcomes, and to provide evidence for improving the success rate of VF. METHODS: The data of patients with VF admitted to Shanghai Medical Emergency Center from January 2013 to December 2016 were analyzed retrospectively. All the data were recorded including the clinical data, medical service time, return of spontaneous circulation (ROSC) at scene/en route, survival to hospital discharge...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29016817/association-between-socioeconomic-factors-and-icd-implantation-in-a-publicly-financed-health-care-system-a-danish-nationwide-study
#6
Matilde Winther-Jensen, Christian Hassager, Jens Flensted Lassen, Lars Køber, Christian Torp-Pedersen, Steen Møller Hansen, Freddy Lippert, Erika Frischknecht Christensen, Kristian Kragholm, Jesper Kjaergaard
Aims: For patients surviving out-of-hospital cardiac arrest (OHCA) with a shockable rhythm, implantable cardioverter defibrillator (ICD) is recommended for non-reversible causes of arrest. We aimed to determine factors associated with implantation of ICD and survival in patients surviving non-AMI OHCA in a nationwide register covering all OHCAs in Denmark. Methods and results: We identified 36 950 OHCAs between 2001 and 2012, 1700 of whom were ICD naïve, ≥18 years, of non-AMI cardiac aetiology and surviving until discharge...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28993605/a-case-of-diffuse-alveolar-hemorrhage-as-a-possible-complication-of-bivalirudin-therapy
#7
Htun Latt, Sammy Aung, Kyaw Kyaw, Thein Tun Aung, Chanwit Roongsritong
BACKGROUND Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal complication of anticoagulant or antiplatelet therapy. Bivalirudin is a specific and reversible direct thrombin inhibitor (DTI). CASE REPORT We report a case of severe DAH, possibly related to bivalirudin use, in a 61-year-old patient undergoing coronary intervention. The patient had presented with an out-of-hospital cardiac arrest due to acute ST elevation myocardial infarction (STEMI). During the coronary intervention, shortly after receiving bivalirudin, the patient started having frank bleeding from the endotracheal tube and developed hemodynamic compromise...
October 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28993522/cardiopulmonary-resuscitation-on-television-are-we-miseducating-the-public
#8
Michael Colwill, Charlotte Somerville, Eric Lindberg, Caroline Williams, James Bryan, Ted Welman
BACKGROUND: Out-of-hospital cardiac arrest survival rates in the UK are poor, and non-medically trained individuals have been identified to perform substandard cardiopulmonary resuscitation (CPR). Millions watch televised medical dramas and, for many, these comprise their only education on CPR. This study aims to investigate the quality of CPR portrayed on these programmes and whether this has an effect on public knowledge. METHODS: Prospective observational study of 30 consecutive episodes of three popular medical dramas...
October 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#9
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
October 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28988657/experiences-of-surviving-a-cardiac-arrest-after-therapeutic-hypothermia-treatment-an-interview-study
#10
Margareta Brännström, Camilla Niederbach, Ann-Charlotte Rödin
BACKGROUND: Cardiac arrest (CA) is often associated with high mortality. In Sweden, it is reported that 13-52 per 100,000 people suffer out-of-hospital CA, and survival to one month is 2-14%. OBJECTIVE: This study aimed to describe people's experiences of surviving a CA after therapeutic hypothermia treatment. METHOD: A descriptive qualitative design was used. Data were collected through individual interviews with seven CA survivors. The collected data were analyzed using qualitative content analysis...
October 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28986863/prognostic-implications-of-blood-lactate-concentrations-after-cardiac-arrest-a-retrospective-study
#11
Antonio Maria Dell'Anna, Claudio Sandroni, Irene Lamanna, Ilaria Belloni, Katia Donadello, Jacques Creteur, Jean-Louis Vincent, Fabio Silvio Taccone
BACKGROUND: Elevated lactate concentration has been associated with increased mortality after out-of-hospital cardiac arrest (CA). We investigated the variables associated with high blood lactate concentrations and explored the relationship between blood lactate and neurological outcome in this setting. METHODS: This was a retrospective analysis of an institutional database that included all adult (> 18 years) patients admitted to a multidisciplinary Department of Intensive Care between January 2009 and January 2013 after resuscitation from CA...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28986855/outcome-of-in-and-out-of-hospital-cardiac-arrest-survivors-with-liver-cirrhosis
#12
Kevin Roedl, Christian Wallmüller, Andreas Drolz, Thomas Horvatits, Karoline Rutter, Alexander Spiel, Julia Ortbauer, Peter Stratil, Pia Hubner, Christoph Weiser, Jasmin Katrin Motaabbed, Dominik Jarczak, Harald Herkner, Fritz Sterz, Valentin Fuhrmann
BACKGROUND: Organ failure increases mortality in patients with liver cirrhosis. Data about resuscitated cardiac arrest patients with liver cirrhosis are missing. This study aims to assess aetiology, survival and functional outcome in patients after successful cardiopulmonary resuscitation (CPR) with and without liver cirrhosis. METHODS: Analysis of prospectively collected cardiac arrest registry data of consecutively hospital-admitted patients following successful CPR was performed...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28986388/shocking-the-system-aeds-in-military-resuscitation
#13
REVIEW
Andrew M Buckley, A T Cox, P Rees
Automated external defibrillator (AED) devices have been in routine clinical use since the early 1990s to deliver life-saving shocks to appropriate patients in non-clinical environments. As expectations of survival from out-of-hospital cardiac arrest increase, and evidence incontrovertibly points to reduced timelines as the most crucial factor in achieving return of spontaneous circulation, questions regarding the availability and location of AEDs in the UK military need to be readdressed. This article explores the background of AEDs and reviews their history, life-saving potential and defines current and best practice...
October 5, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#14
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28984671/early-coronary-angiography-for-survivors-of-out-of-hospital-cardiac-arrests-without-st-elevation
#15
Michael Goldfarb, Bojan Cercek
There are over 300,000 out-of-hospital cardiac arrests (OOHCA) in the United States each year, and the long-term survival rate is less than 10%. Despite improvements in postarrest management, the greatest drop-off in survival occurs during hospitalization, mostly due to myocardial dysfunction and neurological injury. Coronary artery disease is common in postcardiac arrest patients, with an incidence of approximately 60-80%. In patients with a chest pain syndrome and an ST-segment-elevation myocardial infarction pattern evident on the presenting electrocardiogram, immediate revascularization is recommended by cardiovascular societies due to established mortality benefits...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28983759/myocardial-dysfunction-after-out-of-hospital-cardiac-arrest-predictors-and-prognostic-implications
#16
Yuan Yao, Nicholas James Johnson, Sarah Muirhead Perman, Vimal Ramjee, Anne Victoria Grossestreuer, David Foster Gaieski
We aim to determine the incidence of early myocardial dysfunction after out-of-hospital cardiac arrest, risk factors associated with its development, and association with outcome. A retrospective chart review was performed among consecutive out-of-hospital cardiac arrest (OHCA) patients who underwent echocardiography within 24 h of return of spontaneous circulation at three urban teaching hospitals. Our primary outcome is early myocardial dysfunction, defined as a left ventricular ejection fraction < 40% on initial echocardiogram...
October 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28979980/association-of-public-health-initiatives-with-outcomes-for-out-of-hospital-cardiac-arrest-at-home-and-in-public-locations
#17
Christopher B Fordyce, Carolina M Hansen, Kristian Kragholm, Matthew E Dupre, James G Jollis, Mayme L Roettig, Lance B Becker, Steen M Hansen, Tomoya T Hinohara, Claire C Corbett, Lisa Monk, R Darrell Nelson, David A Pearson, Clark Tyson, Sean van Diepen, Monique L Anderson, Bryan McNally, Christopher B Granger
Importance: Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor. Objective: To describe temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes...
October 4, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28979976/improving-outcomes-after-out-of-hospital-cardiac-arrest
#18
Terence Valenzuela, Andrew J Harrell, Graham Nichol
No abstract text is available yet for this article.
October 4, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28979514/a-case-for-stopping-the-early-withdrawal-of-life-sustaining-therapies-in-patients-with-devastating-brain-injuries
#19
Alex R Manara, Ian Thomas, Richard Harding
Early prognostication in patients with a devastating brain injury is not always accurate and can lead to inappropriate decisions. We present case histories to support the recent recommendations of the Neurocritical Care Society that treatment withdrawal decisions should be delayed by up to 72 h in these patients. Development of pathways incorporating these recommendations can improve prognostication, enhance end of life care given to these patients and their families, and increase the opportunities to explore the donation wishes of more patients...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978527/dispatch-of-firefighters-and-police-officers-in-out-of-hospital-cardiac-arrest-a-nationwide-prospective-cohort-trial-using-propensity-score-analysis
#20
Ingela Hasselqvist-Ax, Per Nordberg, Johan Herlitz, Leif Svensson, Martin Jonsson, Jonny Lindqvist, Mattias Ringh, Andreas Claesson, Johan Björklund, Jan-Otto Andersson, Caroline Ericson, Pär Lindblad, Lars Engerström, Mårten Rosenqvist, Jacob Hollenberg
BACKGROUND: Dispatch of basic life support-trained first responders equipped with automated external defibrillators in addition to advanced life support-trained emergency medical services personnel in out-of-hospital cardiac arrest (OHCA) has, in some minor cohort studies, been associated with improved survival. The aim of this study was to evaluate the association between basic life support plus advanced life support response and survival in OHCA at a national level. METHODS AND RESULTS: This prospective cohort study was conducted from January 1, 2012, to December 31, 2014...
October 4, 2017: Journal of the American Heart Association
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