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Prehospital cardiac arrest

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https://www.readbyqxmd.com/read/28874938/availability-and-accuracy-of-ems-information-about-chronic-health-and-medications-in-cardiac-arrest
#1
Alexander Foster, Victor Florea, Carol Fahrenbruch, Jennifer Blackwood, Thomas D Rea
INTRODUCTION: Field information available to emergency medical services (EMS) about a patient's chronic health conditions or medication therapies could help direct patient care or be used to investigate outcome disparities. However, little is known about the field availability or accuracy of information of chronic health conditions or chronic medication treatments in emergent circumstances, especially when the patient cannot serve as an information resource. We evaluated the prehospital availability and accuracy of specific chronic health conditions and medication treatments among out-of-hospital cardiac arrest (OHCA) patients...
August 2017: Western Journal of Emergency Medicine
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
#2
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/28843461/a-new-rule-for-terminating-resuscitation-of-out-of-hospital-cardiac-arrest-patients-in-japan-a-prospective-study
#3
(no author information available yet)
BACKGROUND: The American Heart Association and European Resuscitation Council guidelines for cardiopulmonary resuscitation present rules for termination of resuscitation (TOR) in cases of out-of-hospital cardiac arrest (OHCA). In Japan, only doctors are legally allowed TOR in OHCA cases. OBJECTIVE: This study aimed to develop a new TOR rule that suits the actual situations of the Japanese emergency medical services system. METHODS: Five different combinations of the TOR rule criteria were compared regarding specificity and positive predictive value (PPV) for 1-month survival with unfavorable neurologic outcomes...
August 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28837291/-prehospital-misconceptions
#4
Eduardo Alcouce, Vincent Darioli, Pierre-Nicolas Carron, Mathieu Pasquier
We confronted some of the most prevalent prehospital misconceptions with the available literature. We found that: the diminution of a retrosternal pain following nitrate administration is not predictive of a cardiac origin of the pain ; survival of traumatic cardiac arrest may not be as bad as usually believed ; peripheral venous administration of vasopressors through proximal catheters during short times may be considered as a safe temporary alternative to central venous access ; using the pulse palpation usually lead to an under-estimation of the systolic blood pressure ; applying a pelvic belt at the level of the iliac crests doesn't aggravate an open-book fracture; there is no 90 mmHg threshold values below which mortality increases in traumatic brain injuries...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#5
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
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
#6
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 2005-2016, 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 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28789991/potential-impact-of-a-prehospital-redirection-system-for-refractory-cardiac-arrest
#7
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/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
#8
RANDOMIZED CONTROLLED TRIAL
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/28741008/the-national-resuscitation-council-singapore-and-34-years-of-resuscitation-training-1983-to-2017
#9
Venkataraman Anantharaman
Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC)...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741005/the-pan-asian-resuscitation-outcomes-study-paros-clinical-research-network-what-where-why-and-how
#10
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/28723789/measuring-the-impact-of-emergency-medical-services-ems-on-out-of-hospital-cardiac-arrest-survival-in-a-developing-country-a-key-metric-for-ems-systems-performance
#11
Mazen El Sayed, Reem Al Assad, Yasmin Abi Aad, Nour Gharios, Marwan M Refaat, Hani Tamim
Out-of-hospital cardiac arrest (OHCA) can be used to evaluate the overall performance of the emergency medical services' (EMS) system. This study assessed the impact of EMS on OHCA survival rates in a setting where the prehospital system is underdeveloped.A retrospective chart review was carried out over a 5-year period of all adult OHCA patients admitted to the emergency department (ED) of a tertiary care center in Lebanon.A total of 271 patients with OHCA (179 [66.1%] men, mean age of 69.9 [standard deviation = 15...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#12
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation after cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series. If there is a threshold below which survival was extremely unlikely, it might be useful in guiding decision-making in the early termination of futile resuscitative efforts...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28698191/manual-versus-semiautomatic-rhythm-analysis-and-defibrillation-for-out-of-hospital-cardiac-arrest
#13
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
https://www.readbyqxmd.com/read/28698134/effects-of-advanced-life-support-on-patients-who-suffered-cardiac-arrest-outside-of-hospital-and-were-defibrillated
#14
Akihito Hagihara, Daisuke Onozuka, Takashi Nagata, Manabu Hasegawa
BACKGROUND: The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood. METHODS: This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28676243/characteristics-of-hospitalizations-for-cardiogenic-shock-after-acute-myocardial-infarction-in-the-united-states
#15
Udhay Krishnan, Josef A Brejt, Joshua Schulman-Marcus, Rajesh V Swaminathan, Dmitriy N Feldman, S Chiu Wong, Parag Goyal, Evelyn M Horn, Maria Karas, Irina Sobol, Robert M Minutello, Geoffrey Bergman, Harsimran Singh, Luke K Kim
BACKGROUND: Multiple studies have reported a decline in mortality for patients with cardiogenic shock after acute myocardial infarction (CS-AMI), a finding which has been attributed to an increase in revascularization over the past decade. However, other studies that have focused on CS-AMI patients treated with early percutaneous coronary intervention (PCI) have found no improvement in risk-adjusted mortality. To reconcile these discordances, we hypothesize that the clinical complexity of the PCI-population has changed over time, in ways not precisely adjusted for in previous studies...
June 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28673308/two-cases-of-low-birth-weight-infant-survival-by-prehospital-emergency-hysterotomy
#16
Miretta Tommila, Mikko Pystynen, Hanna Soukka, Fatih Aydin, Matias Rantanen
BACKGROUND: During maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location. In addition to this, gestational age is an important determinant to neonatal outcome...
July 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28663360/public-knowledge-of-cardiovascular-disease-and-response-to-acute-cardiac-events-in-three-cities-in-china-and-india
#17
Herbert C Duber, Claire R McNellan, Alexandra Wollum, Bryan Phillips, Kate Allen, Jonathan C Brown, Miranda Bryant, R B Guptam, Yichong Li, Piyusha Majumdar, Gregory A Roth, Blake Thomson, Shelley Wilson, Alexander Woldeab, Maigeng Zhou, Marie Ng
OBJECTIVE: To inform interventions targeted towards reducing mortality from acute myocardial infarction (AMI) and sudden cardiac arrest in three megacities in China and India, a baseline assessment of public knowledge, attitudes and practices was performed. METHODS: A household survey, supplemented by focus group and individual interviews, was used to assess public understanding of cardiovascular disease (CVD) risk factors, AMI symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs)...
June 29, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28655622/increased-cardiac-arrest-survival-and-bystander-intervention-in-enclosed-pedestrian-walkway-systems
#18
Minha Lee, Derya Demirtas, Jason E Buick, Michael J Feldman, Sheldon Cheskes, Laurie J Morrison, Timothy C Y Chan
BACKGROUND: Cities worldwide have underground or above-ground enclosed walkway systems for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrests (OHCAs). The characteristics and outcomes of OHCAs that occur in such systems are unknown. OBJECTIVE: To determine whether OHCAs occurring in enclosed pedestrian walkway systems have differing demographics, prehospital intervention, and survival outcomes compared to the encompassing city, by examining the PATH walkway system in Toronto...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28648808/are-characteristics-of-hospitals-associated-with-outcome-after-cardiac-arrest-insights-from-the-great-paris-registry
#19
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/28646584/prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest-a-cohort-study
#20
Alexis Cournoyer, Éric Notebaert, Massimiliano Iseppon, Sylvie Cossette, Luc Londei-Leduc, Yoan Lamarche, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Catalina Sokoloff, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
OBJECTIVES: Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC), and delay from call to hospital arrival...
September 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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