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Traumatic cardiac arrest

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https://www.readbyqxmd.com/read/28802878/prehospital-sodium-bicarbonate-use-could-worsen-long-term-survival-with-favorable-neurological-recovery-among-patients-with-out-of-hospital-cardiac-arrest
#1
Takahisa Kawano, Brian Grunau, Frank X Scheuermeyer, Koichiro Gibo, William Dick, Christopher B Fordyce, Paul Dorian, Robert Stenstrom, Ronald Straight, Jim Christenson
BACKGROUND: Sodium bicarbonate (SB) is widely used for resuscitation in out-of- hospital cardiac arrest (OHCA); however, its effect on long term outcomes is unclear. METHODS: From 2005 to 2016, we prospectively conducted a province-wide population-based observational study including adult non-traumatic OHCA patients managed by paramedics. SB was administered by paramedics based on their clinical assessments. To examine the association of SB administration and survival and favorable neurological outcome to hospital discharge, defined as modified Rankin scale of 3 or less, we performed a multivariable logistic regression analysis: (1) within propensity score matched comparison groups, and; (2) within the full cohort with missing variables addressed by multiple imputation techniques...
August 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28801484/predicting-outcomes-in-traumatic-out-of-hospital-cardiac-arrest-the-relevance-of-utstein-factors
#2
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801040/extracorporeal-cardiopulmonary-resuscitation-for-blunt-cardiac-rupture-a-case-report
#3
Shunsuke Kudo, Keiji Tanaka, Kunihiko Okada, Takahiro Takemura
Extracorporeal cardiopulmonary resuscitation (ECPR) followed by operating room sternotomy, rather than resuscitative thoracotomy, might be life-saving for patients with blunt cardiac rupture and cardiac arrest who do not have multiple severe traumatic injuries. A 49-year-old man was injured in a vehicle crash and transferred to the emergency department. On admission, he was hemodynamically stable, but a plain chest radiograph revealed a widened mediastinum, and echocardiography revealed hemopericardium. A computed tomography scan revealed hemopericardium and mediastinal hematoma, without other severe traumatic injuries...
August 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28791755/emergency-department-use-of-apneic-oxygenation-versus-usual-care-during-rapid-sequence-intubation-a-randomized-controlled-trial-the-endao-trial
#4
Nicholas Caputo, Ben Azan, Rui Domingues, Lee Donner, Mark Fenig, Douglas Fields, Robert Fraser, Karlene Hosford, Richard Iuorio, Marc Kanter, Moira McCarty, Thomas Parry, Andaleeb Raja, Mary Ryan, Blaine Williams, Hemlata Sharma, Daniel Singer, Chris Shields, Sandra Scott, Jason R West
OBJECTIVES: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. METHODS: A randomized controlled trial was conducted at an academic, urban, level 1 trauma center...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28789991/potential-impact-of-a-prehospital-redirection-system-for-refractory-cardiac-arrest
#5
Alexis Cournoyer, Éric Notebaert, Luc de Montigny, Sylvie Cossette, Luc Londei-Leduc, Massimiliano Iseppon, Yoan Lamarche, Catalina Sokoloff, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Dave Ross, Dominique Lafrance, Eli Segal, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
AIM: A change in prehospital redirection practice could potentially increase the proportion of E-CPR eligible patients with out-of-hospital cardiac arrest (OHCA) transported to extracorporeal cardiopulmonary resuscitation (E-CPR) capable centers. The objective of this study was to quantify this potential increase of E-CPR candidates transported to E-CPR capable centers. METHODS: Adults with non-traumatic OHCA refractory to 15min of resuscitation were selected from a registry of adult OHCA collected between 2010 and 2015 in Montreal, Canada...
August 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28781898/suicide-by-ingestion-of-caffeine
#6
Frédéric Aknouche, Emilie Guibert, Alison Tessier, Aude Eibel, Pascal Kintz
BACKGROUND: Mr K, aged 48, was found sweating by his partner at home at 11.50 pm. He claimed to have attempted suicide. She immediately called the Emergency Unit to ask for support. At the phone, the physician on duty indicated her to give a pill of Lysanxia (prazepam) to decrease the level of stress of the victim. However, the clinical situation worsened and he was taken to the hospital at 1.00 am. At his arrival at 1.28 am he was in cardiac arrest. Despite intensive resuscitation manoeuvres, death was pronounced at 2...
2017: Egyptian journal of forensic sciences
https://www.readbyqxmd.com/read/28772171/factors-associated-with-an-increased-risk-of-perioperative-cardiac-arrest-in-emergent-and-elective-craniotomy-and-spine-surgery
#7
Timothy D Quinn, Ethan Y Brovman, Linda S Aglio, Richard D Urman
OBJECTIVE: Cardiac arrest following neurosurgery is a devastating complication associated with significant postoperative morbidity and mortality. There are no published studies that have used a large and robust multicenter database to specifically examine demographic and surgical risk factors associated with cardiac arrests following craniotomy and spine surgeries, respectively. PATIENTS AND METHODS: We retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the period between January 1, 2007 and December 31, 2013, focusing on cardiac arrest associated with craniotomy and spine surgery from the intraoperative period to 30days after surgery...
July 25, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28754760/accidental-hypothermic-cardiac-arrest-and-rapid-mediastinal-warming-with-pleural-lavage-a-survivor-after-3-5-hours-of-manual-cpr
#8
George Little
A 30-year-old man suffered post-traumatic hypothermic cardiac arrest. On arrival in the emergency department, rectal core temperature was 23°C. Manual cardiopulmonary resuscitation (CPR) was continued as no mechanical chest compression device was available, and active and passive rewarming was undertaken. Bilateral thoracostomies confirmed good lung inflation. Defibrillation and intravenous epinephrine were discontinued until core temperature was elevated above 30°C. Extracorporeal rewarming was unavailable...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#9
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#10
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#11
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#12
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#13
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28648808/are-characteristics-of-hospitals-associated-with-outcome-after-cardiac-arrest-insights-from-the-great-paris-registry
#14
Richard Chocron, Wulfran Bougouin, Frankie Beganton, Philippe Juvin, Thomas Loeb, Frédéric Adnet, Eric Lecarpentier, Lionel Lamhaut, Daniel Jost, Eloi Marijon, Alain Cariou, Xavier Jouven, Florence Dumas
PURPOSE: As post-cardiac arrest care may influence patients' outcome, characteristics of receiving hospitals should be integrated in the evaluation of survival. We aimed at assessing the influence of care level center on patients' survival at hospital discharge using a regional registry of out-of-hospital cardiac arrest patients (OHCA). METHODS: We retrospectively analysed a Utstein and in-hospital data prospectively collected for all non-traumatic OHCA patients, in whom a successful return of spontaneous circulation (ROSC) had been obtained, from a large metropolitan area (Great Paris)...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28639949/comet-assay-in-evaluating-deoxyribonucleic-acid-damage-after-out-of-hospital-cardiac-arrest
#15
Radka Hazuková, Martina Rezácová, Renata Köhlerová, Tomáš Tomek, Eva Cermáková, Jaromír Kocí, Miloslav Pleskot
OBJECTIVE: This study aimed to investigate whether out-of-hospital cardiac arrest (OHCA) may induce severe DNA damage measured using comet assay in successfully resuscitated humans and to evaluate a short-term prognostic role. METHODS: In this prospective, controlled, blinded study (1/2013-1/2014), 41 patients (age, 63±14 years) successfully resuscitated from non traumatic OHCA and 10 healthy controls (age, 53±17 years) were enrolled. DNA damage [double-strand breaks (DSBs) and single-strand breaks (SSBs)] was measured using comet assay in peripheral lymphocytes sampled at admission...
July 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#16
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28624594/variability-in-the-initiation-of-resuscitation-attempts-by-emergency-medical-services-personnel-during-out-of-hospital-cardiac-arrest
#17
Steven C Brooks, Robert H Schmicker, Sheldon Cheskes, Jim Christenson, Alan Craig, Mohamud Daya, Peter J Kudenchuk, Graham Nichol, Dana Zive, Laurie J Morrison
BACKGROUND: Some patients with out-of-hospital cardiac arrest (OHCA) assessed by emergency medical services (EMS) do not receive attempts at resuscitation on the basis of perceived futility. AIMS: 1) To measure variability in the initiation of resuscitation attempts in EMS-assessed OHCA patients across EMS agencies, 2) to evaluate the association between selected EMS agency characteristics and the proportion of patients receiving resuscitation attempts, and 3) to evaluate the association between proportion receiving resuscitation attempts and survival...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28621620/deep-brain-stimulation-for-the-early-treatment-of-the-minimally-conscious-state-and-vegetative-state-experience-in-14-patients
#18
Darko Chudy, Vedran Deletis, Fadi Almahariq, Petar Marčinković, Jasenka Škrlin, Veronika Paradžik
OBJECTIVE An effective treatment of patients in a minimally conscious state (MCS) or vegetative state (VS) caused by hypoxic encephalopathy or traumatic brain injury (TBI) is not yet available. Deep brain stimulation (DBS) of the thalamic reticular nuclei has been attempted as a therapeutic procedure mainly in patients with TBI. The purpose of this study was to investigate the therapeutic use of DBS for patients in VS or MCS. METHODS Fourteen of 49 patients in VS or MCS qualified for inclusion in this study and underwent DBS...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28601315/age-related-mortality-in-blunt-traumatic-hemorrhagic-shock-the-killers-and-the-life-savers
#19
John O Hwabejire, Christine E Nembhard, Tolulope A Oyetunji, Theodros Seyoum, Mayowa P Abiodun, Suryanarayana M Siram, Edward E Cornwell, Wendy R Greene
BACKGROUND: There are sparse data on the association between age and mortality in hemorrhagic shock (HS). We examined this association in this study. MATERIALS AND METHODS: The Glue Grant database was analyzed. Patients aged ≥16 y with blunt traumatic HS were stratified into eight age groups (16-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 y) to identify the mortality inflection point. Subsequently, patients were restratified into young age (16-44 y), middle age (45-64 y), and elderly (≥65 y)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#20
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
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