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Guidelines for cardiopulmonary resuscitation

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https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#1
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28508956/doctors-attitudes-towards-the-introduction-and-clinical-operation-of-do-not-resuscitate-orders-dnrs-in-ireland
#2
M O'Reilly, C M P O'Tuathaigh, K Doran
BACKGROUND: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. AIMS: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. METHODS: A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals...
May 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#3
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 10, 2017: Neurology
https://www.readbyqxmd.com/read/28476474/the-association-between-aha-cpr-quality-guideline-compliance-and-clinical-outcomes-from-out-of-hospital-cardiac-arrest
#4
Sheldon Cheskes, Robert H Schmicker, Tom Rea, Laurie J Morrison, Brian Grunau, Ian R Drennan, Brian Leroux, Christian Vaillancourt, Terri A Schmidt, Allison C Koller, Peter Kudenchuk, Tom P Aufderheide, Heather Herren, Katharyn H Flickinger, Mark Charleston, Ron Straight, Jim Christenson
BACKGROUND: Measures of chest compression fraction (CCF), compression rate, compression depth and pre-shock pause have all been independently associated with improved outcomes from out-of-hospital (OHCA) cardiac arrest. However, it is unknown whether compliance with American Heart Association (AHA) guidelines incorporating all the aforementioned metrics, is associated with improved survival from OHCA. METHODS: We performed a secondary analysis of prospectively collected data from the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest database...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28466294/-cardiac-support-and-replacement-systems
#5
REVIEW
T Graf, H Thiele
In recent years, the widespread use of partial mechanical cardiac support and even temporary complete replacement of cardiac function has been established in many intensive care units in the treatment of refractory cardiogenic shock. There is a difference between partial left-ventricular assist devices (LVAD) and the possibility of complete heart (and lung) replacement by extra corporeal life support (ECLS). Despite the use of mechanical support devices, the mortality of cardiogenic shock remains high. The consideration of using percutaneous LVAD and ECLS in cardiogenic shock should be considered in refractory cardiogenic shock patients in addition to support by catecholamines and after early revascularization in acute coronary syndromes...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28452098/impact-of-bradycardia-or-asystole-on-neonatal-cardiopulmonary-resuscitation-at-birth
#6
Vasantha H S Kumar, Annie Skrobacz, Changxing Ma
BACKGROUND: Fetal hypoxia from intrapartum events can lead to absent heart rate (HR) or bradycardia (BC) at birth requiring aggressive neonatal resuscitation. Neonatal resuscitation guidelines do not differentiate infants with bradycardia (HR<100/min) from absent HR at birth. As HR is the primary determinant of resuscitation, we hypothesize that infants with no HR at 1 minute would require more extensive resuscitation with worse clinical outcomes compared to infants with bradycardia at 1minute...
April 28, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28444125/sudden-cardiac-death
#7
Jagdesh Kandala, Clint Oommen, Karl B Kern
Introduction: Sudden cardiac arrest continues to be the leading cause of death in the industrialized world. Sources of data: Original papers, reviews and guidelines. Areas of agreement: Community programs for lay bystander cardiopulmonary resuscitation (CPR) and automatic external defibrillation improve outcomes. Post-arrest care, including targeted temperature management (TTM) combined with early coronary angiography and percutaneous coronary intervention, is helpful for those suffering cardiac arrest during an ST-segment elevation myocardial infarction...
April 24, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28435854/a-clinical-trial-simulation-evaluating-epinephrine-pharmacokinetics-at-various-dosing-frequencies-during-cardiopulmonary-resuscitation
#8
Andy R Eugene
OBJECTIVE: This article seeks to test the hypothesis that repeated 1mg intravenous epinephrine dosing intervals of 3-minutes and 5-minutes results in differences in the total drug exposure and the maximum epinephrine concentration using simulated cardiopulmonary resuscitation (CPR) dosing. METHODS: Published population pharmacokinetic parameters were identified in the literature and pharmacokinetic dosing simulations were conducted according to the 2015 American Heart Association guidelines for CPR in adults...
June 2016: MEDtube Science
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#9
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28408236/unintentional-pediatric-cocaine-exposures-result-in-worse-outcomes-than-other-unintentional-pediatric-poisonings
#10
Patil Armenian, Michelle Fleurat, George Mittendorf, Kent R Olson
BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. OBJECTIVES: The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. METHODS: This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28404450/does-lying-in-the-recovery-position-increase-the-likelihood-of-not-delivering-cardiopulmonary-resuscitation
#11
Miguel Freire-Tellado, Rubén Navarro-Patón, Maria Del Pilar Pavón-Prieto, Marta Fernández-López, Javier Mateos-Lorenzo, Ivan López-Fórneas
BACKGROUND: Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. AIM: To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation...
April 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28402986/no-small-matter-pediatric-resuscitation
#12
Taylor McCormick, Kevin McVaney, Paul E Pepe
PURPOSE OF REVIEW: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28398908/evolution-and-revolution-in-cardiopulmonary-resuscitation
#13
Ray Fowler, Mary P Chang, Ahamed H Idris
PURPOSE OF REVIEW: To discuss the evolution of the technique of cardiopulmonary resuscitation (CPR), including presenting important research that has made substantial improvements in patient outcome. RECENT FINDINGS: The last half century has seen the arising of guidelines for performing CPR increasingly based on good scientific evidence. Improvements in the technique, including teaching citizens 'compressions only CPR', have simplified the process of rescue while improving survival...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28391604/health-care-professionals-concerns-regarding-in-hospital-family-witnessed-cardiopulmonary-resuscitation-implementation-into-clinical-practice
#14
Natalia Sak-Dankosky, Paweł Andruszkiewicz, Paula R Sherwood, Tarja Kvist
BACKGROUND: In-hospital, family-witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short- and long-term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family-witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation...
April 9, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28385640/bystander-capability-to-activate-speaker-function-for-continuous-dispatcher-assisted-cpr-in-case-of-suspected-cardiac-arrest
#15
Alvilda T Steensberg, Mette M Eriksen, Lars B Andersen, Ole M Hendriksen, Heinrich D Larsen, Gunnar H Laier, Thomas Thougaard
BACKGROUND: The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. METHOD: In 87days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#16
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
April 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28367581/drowning-in-swimming-pools-clinical-features-and-safety-recommendations-based-on-a-study-of-descriptive-records-by-emergency-medical-services-attending-to-995-calls
#17
Joanna Shi-En Chan, Marie Xin Ru Ng, Yih Yng Ng
INTRODUCTION: This study was a descriptive analysis of national ambulance case records, aimed at making practical safety recommendations in order to reduce the incidence of drowning in swimming pools. METHODS: A search was performed on a national database of descriptive summaries by first responder paramedics of all 995 calls made to the Singapore Civil Defence Force between 1 January 2012 and 31 December 2014. We included all cases of submersion in both public and private pools for which emergency medical services were activated...
April 3, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28343180/oxygen-saturation-trends-in-normal-healthy-term-newborns-normal-vaginal-delivery-vs-elective-cesarean-section
#18
Rashi Bhargava, Madhu Mathur, Jyoti Patodia
OBJECTIVES: To study the normal oxygen saturation trends and fetomaternal correlates in healthy term newborns within 30 min of life born by normal vaginal delivery (NVD) and elective cesarean section (CS). MATERIALS AND METHODS: A cross-sectional study was conducted on 200 healthy term newborns born by NVD and elective CS at a tertiary care centre. Routine care as per the Neonatal Resuscitation Program (NRP) 2015 (Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28282762/a-comparison-between-the-two-methods-of-chest-compression-in-infant-and-neonatal-resuscitation-a-review-according-to-2010-cpr-guidelines
#19
Alexandros Douvanas, Christina Koulouglioti, Maria Kalafati
AIM: The quality of chest compression (CC) delivered during neonatal and infant cardiopulmonary resuscitation (CPR) is identified as the most important factor to achieve the increase of survival rate without major neurological deficit to the patients. The objective of the study was to systematically review all the available studies that have compared the two different techniques of hand placement on infants and neonatal resuscitation, from 2010 to 2015 and to highlight which method is more effective...
March 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#20
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
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