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Prehospital cardiac arrest

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https://www.readbyqxmd.com/read/29769232/end-tidal-carbon-dioxide-output-in-manual-cardiopulmonary-resuscitation-versus-active-compression-decompression-device-during-prehospital-quality-controlled-resuscitation-a-case-series-study
#1
Piritta Anniina Setälä, Ilkka Tapani Virkkunen, Antti Jaakko Kämäräinen, Heini Sisko Annamari Huhtala, Janne Severi Virta, Arvi Mikael Yli-Hankala, Sanna Elisa Hoppu
BACKGROUND: Active compression-decompression (ACD) devices have enhanced end-tidal carbon dioxide (ETCO2 ) output in experimental cardiopulmonary resuscitation (CPR) studies. However, the results in out-of-hospital cardiac arrest (OHCA) patients have shown inconsistent outcomes, and earlier studies lacked quality control of CPR attempts. We compared manual CPR with ACD-CPR by measuring ETCO2 output using an audiovisual feedback defibrillator to ensure continuous high quality resuscitation attempts...
May 16, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29763712/cerebral-tissue-oximetry-levels-during-prehospital-management-of-cardiac-arrest-a-prospective-observational-study
#2
Gregor Prosen, Strnad Matej, Stephanie J Doniger, Andrej Markota, Andraž Stožer, Vesna Borovnik-Lesjak, Dušan Mekiš
INTRODUCTION: Near-infrared spectroscopy (NIRS) enables continuous monitoring of regional oximetry (rSO2 ). The aim of this study was to describe dynamics of regional cerebral oximetry levels during out of hospital cardiac arrest (OHCA) resuscitation, specifically around the time of restoration of spontaneous circulation (ROSC). METHODS: This prospective observational study was performed in the prehospital setting during cardio-pulmonary resuscitation (CPR) of OHCA patients...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29752776/influence-of-prehospital-airway-management-on-neurological-outcome-in-patients-transferred-to-a-heart-attack-centre-following-out-of-hospital-cardiac-arrest
#3
Timothy Edwards, Julia Williams, Michaela Cottee
OBJECTIVE: To describe the association between prehospital airway management and neurological outcomes in patients transferred by the ambulance service directly to a heart attack centre (HAC) post-return of spontaneous circulation (ROSC). METHODS: A retrospective observational cohort study in which ambulance records were reviewed to determine prehospital airway management strategy and collect physiological and demographic data. HAC notes were obtained to determine in-hospital management and quantify neurological outcome via the cerebral performance category (CPC) scale...
May 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29714510/does-non-targeted-community-cpr-training-increase-bystander-cpr-frequency
#4
Amy Uber, Richard C Sadler, Todd Chassee, Joshua C Reynolds
OBJECTIVE: Only 37% of out-of-hospital cardiac arrests (OHCA) receive bystander Cardiopulmonary resuscitation (CPR) in Kent County, MI. In May 2014, prehospital providers offered one-time, point-of-contact compression-only CPR training to 2,253 passersby at 7 public locations in Grand Rapids, Michigan. To assess the impact of this intervention, we compared bystander CPR frequency and clinical outcomes in regions surrounding training sites before and after the intervention, adjusting for prehospital covariates...
May 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29710131/in-blunt-traumatic-cardiac-arrest-does-it-really-matter-who-performs-prehospital-advanced-life-support
#5
Sandra DiBrito, Elliott R Haut
No abstract text is available yet for this article.
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29710068/association-of-prehospital-advanced-life-support-by-physician-with-survival-after-out-of-hospital-cardiac-arrest-with-blunt-trauma-following-traffic-collisions-japanese-registry-based-study
#6
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Kei Hayashida, Ichiro Kukita
Importance: Controversy remains as to whether advanced life support (ALS) or basic life support (BLS) is superior for critically ill and injured patients, including out-of-hospital cardiac arrest (OHCA) and major trauma, in the prehospital setting. Objective: To assess whether prehospital ALS should be provided for traumatic OHCA and who should perform it. Design, Setting, and Participants: Japanese government-managed nationwide population-based registry data of patients with OHCA transported to an emergency hospital were analyzed...
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29689354/timing-of-advanced-airway-management-by-emergency-medical-services-personnel-following-out-of-hospital-cardiac-arrest-a-population-based-cohort-study
#7
Junichi Izawa, Taku Iwami, Koichiro Gibo, Masashi Okubo, Kentaro Kajino, Kousuke Kiyohara, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takeyuki Kiguchi, Daisuke Kobayashi, Sho Komukai, Takashi Kawamura, Clifton W Callaway, Tetsuhisa Kitamura
BACKGROUND: Early prehospital advanced airway management (AAM) by emergency medical services (EMS) personnel has been intended to improve patient outcomes from out-of-hospital cardiac arrest (OHCA). However, few studies examine the effectiveness of early prehospital AAM. We investigated whether early prehospital AAM was associated with functionally favourable survival after adult OHCA. METHODS: We conducted a population-based cohort study of OHCA in Osaka, Japan, between 2005 and 2012...
April 21, 2018: Resuscitation
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#8
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29685475/iatrogenic-tracheal-rupture-caused-by-emergency-intubation-a-case-report
#9
Christopher Schaeffer, Thomas Galas, Bettina Teruzzi, Jerome Sudrial, Nicolas Allou, Olivier Martinet
BACKGROUND: Iatrogenic tracheal rupture is a rare but life-threatening complication. If suspected by clinical examination or chest radiograph, a computed tomography scan can confirm the diagnosis, but the criterion standard is a bronchoscopy. There is no consensus on its management. CASE REPORT: A 52-year-old woman was intubated in a prehospital setting after cardiac arrest. A gradual appearance of subcutaneous emphysema was observed after intubation. A computed tomography scan revealed a complicated tracheal rupture, pneumomediastinum, and pneumothorax...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29684433/oxygen-titration-after-resuscitation-from-out-of-hospital-cardiac-arrest-a-multi-centre-randomised-controlled-pilot-study-the-exact-pilot-trial
#10
Janet E Bray, Cindy Hein, Karen Smith, Michael Stephenson, Hugh Grantham, Judith Finn, Dion Stub, Peter Cameron
INTRODUCTION: Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. METHODS: We enrolled unconscious adults with: sustained ROSC; initial shockable rhythm; an advanced airway; and an SpO2 ≥ 95%...
April 20, 2018: Resuscitation
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#11
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669574/effects-of-modifiable-prehospital-factors-on-survival-after-out-of-hospital-cardiac-arrest-in-rural-versus-urban-areas
#12
Wenche Torunn Mathiesen, Conrad Arnfinn Bjørshol, Jan Terje Kvaløy, Eldar Søreide
BACKGROUND: The modifiable prehospital system factors, bystander cardiopulmonary resuscitation (CPR), emergency medical services (EMS), response time, and EMS physician attendance, may affect short- and long-term survival for both rural and urban out-of-hospital cardiac arrest (OHCA) patients. We studied how such factors influenced OHCA survival in a mixed urban/rural region with a high survival rate after OHCA. METHODS: We analyzed the association between modifiable prehospital factors and survival to different stages of care in 1138 medical OHCA patients from an Utstein template-based cardiac arrest registry, using Kaplan-Meier type survival curves, univariable and multivariable logistic regression and mortality hazard plots...
April 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29618372/prehospital-triage-of-patients-diagnosed-with-perforated-peptic-ulcer-or-peptic-ulcer-bleeding-an-observational-study-of-patients-calling-1-1-2
#13
Kasper Bonnesen, Kristian D Friesgaard, Morten T Boetker, Lone Nikolajsen
BACKGROUND: Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB)...
April 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29617208/analysis-of-prehospital-scene-times-and-interventions-on-mortality-outcomes-in-a-national-cohort-of-penetrating-and-blunt-trauma-patients
#14
Octavia S Ruelas, Craig F Tschautscher, Christine M Lohse, Matthew D Sztajnkrycer
BACKGROUND: Recent studies have suggested improved outcomes in victims of penetrating trauma managed with shorter prehospital times and limited interventions. The purpose of the current study was to perform an outcome analysis of patients transported following penetrating and blunt traumatic injuries. METHODS: We performed a descriptive retrospective analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set for patients presenting after acute traumatic injury...
April 4, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29613954/left-ventricular-compressions-improve-return-of-spontaneous-circulation-and-hemodynamics-in-a-swine-model-of-traumatic-cardiopulmonary-arrest
#15
Kenton L Anderson, Kristin C Fiala, Maria G Castaneda, Susan M Boudreau, Allyson A Araña, Vikhyat S Bebarta
BACKGROUND: Prehospital cardiopulmonary resuscitation, including closed chest compressions, has commonly been considered ineffective in traumatic cardiopulmonary arrest (TCPA) because traditional chest compressions do not produce substantial cardiac output. However, recent evidence suggests that chest compressions located over the left ventricle produce greater hemodynamics when compared to traditional compressions. We hypothesized that chest compressions located directly over the left ventricle would improve return of spontaneous circulation (ROSC) and hemodynamics, when compared to traditional chest compressions, in a swine model of traumatic cardiopulmonary arrest (TCPA)...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29602932/-the-epidemiology-of-sudden-cardiac-arrest-in-prehospital-care-in-the-area-of-the-silesian-voivodeship
#16
Klaudiusz Nadolny, Joanna Gotlib, Mariusz Panczyk, Jerzy Robert Ładny, Zbigniew Białczak, Marcin Podgórski, Oksana Makar, Nataliya Izhytska, Robert Gałązkowski
OBJECTIVE: Introduction: Sudden cardiac arrest (SCA) is a serious medical and social issue. The incidence of SCA varies depending on the location and the circumstances. The aim: A retrospective analysis of non-hospital SCA cases from an epidemiological perspective. The research involved the population monitored by the Voivodeship Rescue Service (VRS) in Katowice. PATIENTS AND METHODS: Material and methods The analysis covered dispatch order forms and emergency medical procedure forms of the VRS in Katowice in 2016 (n = 249 872)...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29568528/achieving-the-earliest-possible-reperfusion-in-patients-with-acute-coronary-syndrome-a-current-overview
#17
REVIEW
Takahiro Nakashima, Yoshio Tahara
Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. Appropriate management of ACS will lead to a lower incidence of cardiac arrest. Percutaneous coronary intervention (PCI) is the first-line treatment for patients with ACS. PCI techniques have become established. Thus, the establishment of a system of health care in the prehospital and emergency department settings is needed to reduce mortality in patients with ACS. In this review, evidence on how to achieve earlier diagnosis, therapeutic intervention, and decision to reperfuse with a focus on the prehospital and emergency department settings is systematically summarized...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29564473/-palliative-medicine-in-emergency-medical-services
#18
REVIEW
M Roessler, N Eulitz
The scope of emergency calls for emergency medical services staffed by an emergency physician (EMS-EP) includes calls to patients with life-limiting diseases. Symptom exacerbation as well as psychosocial overburdening of caring relatives are the most frequent reasons for activation of an EMS-EP. Pain crises, acute dyspnea, massive bleeding and/or an impending or overt cardiac arrest are the most frequent symptom exacerbations. Under the conditions of a prehospital emergency physician mission, particular challenges are the evaluation of the overall situation, the prognosis and the presumed will of the patient...
March 21, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29560009/refractory-ventricle-arrhythmias-alternating-with-pulseless-electrical-activity-in-a-young-woman-rescued-by-extracorporeal-cardiopulmonary-resuscitation
#19
Ilona Lálová, Lucie Filipovská, Hana Skalická, Ondřej Šmíd, Aleš Linhart, Helena Kollárová, Jan Bělohlávek
Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation: The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29536862/out-of-hospital-cardiac-arrest-prehospital-management
#20
REVIEW
Marcus Eng Hock Ong, Gavin D Perkins, Alain Cariou
Sudden out-of-hospital cardiac arrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiac arrest, we considered important issues in the prehospital management of cardiac arrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff...
March 10, 2018: Lancet
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