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Traumatic cardiac arrest

Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: -Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest (OHCA), and case features justifying longer or shorter durations are ill-defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in OHCA using a large, multi-center cohort. METHODS: -Secondary analysis of a North American, single blind, multi-center, cluster-randomized clinical trial (ROC-PRIMED) of consecutive adults with non-traumatic, EMS-treated, OHCA...
October 19, 2016: Circulation
Thomas Beez, Jennifer Brown
BACKGROUND: Atlanto-occipital dislocation (AOD) is a rare but severe sequela of high energy trauma. Children are at increased risk, due to their immature spine and biomechanical characteristics. LITERATURE REVIEW: The prevailing mechanism of injury is motor vehicle collision as passenger. AOD commonly presents with cardiorespiratory arrest, spinal cord injury or cranial nerve deficits. Concomitant injuries, such as traumatic brain injury, are frequently encountered...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Dae-Hee Choi, Youn-Jung Kim, Seung Mok Ryoo, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Ju Yong Lim, Won Young Kim
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered as a rescue therapy for patients with refractory cardiac arrest. Identifying patients who might benefit from this potential life-saving procedure is crucial for implementation of ECPR. The objective of this study was to estimate the number of patients who fulfilled a hypothetical set of ECPR criteria and to evaluate the outcome of ECPR candidates treated with conventional cardiopulmonary resuscitation. METHODS: We performed an observational study using data from a prospective registry of consecutive adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest in a tertiary hospital between January 2011 and December 2015...
September 2016: Clin Exp Emerg Med
Tiffany Healey, Clifford Buckley, Matthew Mollman
BACKGROUND: Brugada syndrome is a genetic disorder that increases an individual's risk for sudden cardiac death and ventricular dysrhythmias that was first described by the Brugada brothers in 1992. Brugada syndrome is characterized by an atypical electrocardiogram pattern that includes a bundle branch block and ST-segment elevation in the precordial leads. CASE REPORT: A 74-year-old man had a cardiac arrest at the time of a low-speed motor vehicle collision. When emergency medical services arrived, the patient was in torsades de pointes...
October 14, 2016: Journal of Emergency Medicine
Kai Oliver Jensen, Leonhard Held, Andrea Kraus, Frank Hildebrand, Philipp Mommsen, Ladislav Mica, Guido A Wanner, Peter Steiger, Rudolf M Moos, Hans-Peter Simmen, Kai Sprengel
BACKGROUND: Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. METHODS: In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included...
October 6, 2016: European Journal of Medical Research
Jodi Taylor, Sarah Black, Stephen J Brett, Kim Kirby, Jerry P Nolan, Barnaby C Reeves, Maria Robinson, Chris A Rogers, Lauren J Scott, Adrian South, Elizabeth A Stokes, Matthew Thomas, Sarah Voss, Sarah Wordsworth, Jonathan R Benger
Health outcomes after out of hospital cardiac arrest (OHCA) are extremely poor, with only 7-9% of patients in the United Kingdom (UK) surviving to hospital discharge. Currently emergency medical services (EMS) use either tracheal intubation or newer supraglottic airway devices (SGAs) to provide advanced airway management during OHCA. Equipoise between the two techniques has led to calls for a well-designed randomised controlled trial. The primary objective of the AIRWAYS-2 trial is to assess whether the clinical effectiveness of the i-gel, a second-generation SGA, is superior to tracheal intubation in the initial airway management of OHCA patients in the UK...
September 30, 2016: Resuscitation
Paul T Engels, Mete Erdogan, Sandy L Widder, Michael B Butler, Nelofar Kureshi, Kate Martin, Robert S Green
BACKGROUND: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients. METHODS: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
James Bailey, Ross P Berkeley
A 13-year-old girl had a witnessed loss of consciousness after a scuffle with another student at school and was found in ventricular fibrillation at the time of arrival of emergency medical services personnel. The patient was successfully defibrillated in the field and was transported to the emergency department as a presumed "traumatic arrest". The patient's initial electrocardiogram was remarkable for a prolonged QT interval, and it was discovered that multiple family members had died of cardiac events as young adults...
September 23, 2016: Pediatric Emergency Care
Joonghee Kim, Kyuseok Kim, Clifton W Callaway, Kibbeum Doh, Jungho Choi, Jongdae Park, You Hwan Jo, Jae Hyuk Lee
PURPOSE: The probability of the return of spontaneous circulation (ROSC) and subsequent favourable outcomes changes dynamically during advanced cardiac life support (ACLS). We sought to model these changes using time-to-event analysis in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Adult (≥18 years old), non-traumatic OHCA patients without prehospital ROSC were included. Utstein variables and initial arterial blood gas measurements were used as predictors...
September 19, 2016: Resuscitation
Martin Christ, Katharina Isabel von Auenmueller, Michael Brand, Scharbanu Amirie, Benjamin Michel Sasko, Hans-Joachim Trappe
BACKGROUND The clinical effect of hyperoxia in patients with non-traumatic out-of-hospital cardiac arrest (OHCA) remains uncertain. We therefore initiated this study to find out whether there is an association between survival and hyperoxia early after return of spontaneous circulation (ROSC) in OHCA patients admitted to our hospital. MATERIAL AND METHODS All OHCA patients admitted to our hospital between 1 January 2008 and 30 June 2015 were identified by analysis of our central admission register. Data from individual patients were collected from patient health records and anonymously stored on a central database...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sanjeev Bhoi, Prakash Ranjan Mishra, Kapil Dev Soni, Upendra Baitha, Tej Prakash Sinha
INTRODUCTION: There is a paucity of literature on prehospital care and epidemiology of traumatic cardiac arrest (TCA) in India. This study highlights the profile and characteristics of TCA. METHODS: A retrospective cohort study was conducted to study epidemiological profile of TCA patients ≥1 year presenting to a level 1 trauma center of India. RESULTS: One thousand sixty-one patients were recruited in the study. The median age (interquartile range) was 32 (23-45) years (male:female ratio of 5...
August 2016: Indian Journal of Critical Care Medicine
Karl Sporer, Michael Jacobs, Leo Derevin, Sue Duval, James Pointer
OBJECTIVE: To assess system-wide implementation of specific therapies focused on perfusion during cardiopulmonary resuscitation (CPR) and cerebral recovery after Return of Spontaneous Circulation (ROSC). METHODS: Before and after retrospective analysis of an out-of-hospital cardiac arrest database. Implementation trial in the urban/suburban community of Alameda County, California, USA, population 1.6 million, from November 2009-December 2012. Adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA) who received CPR and/or defibrillation...
September 14, 2016: Prehospital Emergency Care
Rachel M Stanley, Michael D Johnson, Cheryl Vance, Lalit Bajaj, Lynn Babcock, Shireen Atabaki, Danny Thomas, Harold K Simon, Daniel M Cohen, Daniel Rubacalva, P David Adelson, Blake Bulloch, Alexander J Rogers, Prashant Mahajan, Jill Baren, Lois Lee, John Hoyle, Kimberly Quayle, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVES: In preparation for a clinical trial of therapeutic agents for children with moderate-to-severe blunt traumatic brain injuries (TBIs) in emergency departments (EDs), we conducted this feasibility study to 1) determine the number and clinical characteristics of eligible children, 2) determine the timing of patient and guardian arrival to the ED, and 3) describe the heterogeneity of TBIs on computed tomography (CT) scans. METHODS: We conducted a prospective observational study at 16 EDs of children ≤ 18 years of age presenting with blunt head trauma and Glasgow Coma Scale (GCS) scores of 3-12...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
J Zwingmann, R Lefering, M Feucht, N P Südkamp, P C Strohm, T Hammer
BACKGROUND: Data of the TraumaRegister DGU® were analyzed to derive survival rates, neurological outcome and prognostic factors of patients who had suffered traumatic cardiac arrest in the early treatment phase. METHODS: The database of the TraumaRegister DGU® from 2002 to 2013 was analyzed. The main focus of this survey was on different time points of performed resuscitation. Descriptive and multivariate analyses (logistic regression) were performed with the neurological outcome (Glasgow Outcome Scale) and survival rate as the target variable...
September 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
Yecheng Liu, Zhuang Tian, Chunhua Yu, Joseph Walline, Jun Xu, Huadong Zhu, Xuezhong Yu
BACKGROUND: Although the cardiac pump and the thoracic pump are the two main theories, the actual mechanisms of blood flow during Cardiopulmonary Resuscitation (CPR) in humans are still unclear. The aim of this study was to explore the relationship between the pump mechanism and time after cardiac arrest. METHODS AND RESULTS: 20 patients with non-traumatic cardiac arrest were enrolled in this study. Transesophageal two-dimensional and pulse-doppler echocardiography were used during CPR...
November 15, 2016: International Journal of Cardiology
Tobias Haltmeier, Elizabeth Benjamin, Stefano Siboni, Evren Dilektasli, Kenji Inaba, Demetrios Demetriades
PURPOSE: Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. METHODS: Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008-2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen <3) and a field GCS ≤8 were extracted from NTDB. A 1:1 matching of patients with and without prehospital ETI was performed...
August 27, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Ericka L Fink, David K Prince, Jonathan R Kaltman, Dianne L Atkins, Michael Austin, Craig Warden, Jamie Hutchison, Mohamud Daya, Scott Goldberg, Heather Herren, Janice A Tijssen, James Christenson, Christian Vaillancourt, Ronna Miller, Robert H Schmicker, Clifton W Callaway
AIM: Outcomes for pediatric out-of-hospital cardiac arrest (OHCA) are poor. Our objective was to determine temporal trends in incidence and mortality for pediatric OHCA. METHODS: Adjusted incidence and hospital mortality rates of pediatric non-traumatic OHCA patients from 2007-2012 were analyzed using the 9 region Resuscitation Outcomes Consortium-Epidemiological Registry (ROC-Epistry) database. Children were divided into 4 age groups: perinatal (<3 days), infants (3days-1year), children (1-11 years), and adolescents (12-19 years)...
October 2016: Resuscitation
Ruiying Zheng, Shengyuan Luo, Jinli Liao, Zhihao Liu, Jia Xu, Hong Zhan, Xiaoxing Liao, Yan Xiong, Ahamed Idris
BACKGROUND: The prognostic implication of conversion from initially non-shockable to shockable rhythms in patients with out-of-hospital cardiac arrest (OHCA) remains unclear. Our objective is to determine whether the conversion to shockable rhythms is a reliable predictor of short- and long-term outcomes both in patients who initially presented with pulseless electrical activity (PEA) and in those with asystole. METHODS: A secondary analysis was performed on non-traumatic OHCA cases ≥18 years old with PEA or asystole as initial rhythms, who were treated in the field and enrolled in the Resuscitation Outcomes Consortium (ROC) PRIMED study (clinicaltrials...
October 2016: Resuscitation
Matthew J Bradley, Brandon W Bonds, Luke Chang, Shiming Yang, Peter Hu, Hsiao-Chi Li, Megan L Brenner, Thomas M Scalea, Deborah M Stein
BACKGROUND: Open chest cardiac massage (OCCM) is a commonly performed procedure after traumatic cardiac arrest (TCA). OCCM has been reported to be superior to closed chest compressions (CCC) in animal models and in non-TCA. The purpose of this study is to prospectively compare OCCM versus CCC in TCA using end-tidal carbon dioxide (ETCO2), the criterion standard for determining the effectiveness of chest compressions and detection of return of spontaneous circulation (ROSC), as the surrogate for cardiac output and marker for adequacy of resuscitation...
November 2016: Journal of Trauma and Acute Care Surgery
Andreas Lundin, Therese Djärv, Johan Engdahl, Jacob Hollenberg, Per Nordberg, Annika Ravn-Fischer, Mattias Ringh, Susanne Rysz, Leif Svensson, Johan Herlitz, Peter Lundgren
The aim of this study was to review the literature on human studies of drug therapy in cardiac arrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiac arrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiac arrest were excluded...
January 2016: European Heart Journal. Cardiovascular Pharmacotherapy
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