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EM Critical Care Cardiac Arrest

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38 papers 1000+ followers EM and CC literature regarding cardiac arrest resuscitation.
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/27543137/echocardiography-in-shock-management
#1
REVIEW
Anthony S McLean
Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#2
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
September 27, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27054624/update-on-mechanical-cardiopulmonary-resuscitation-devices
#3
Sten Rubertsson
PURPOSE OF REVIEW: The aim of this review is to update and discuss the use of mechanical chest compression devices in treatment of cardiac arrest. RECENT FINDINGS: Three recently published large multicenter randomized trials have not been able to show any improved outcome in adult out-of-hospital cardiac arrest patients when compared with manual chest compressions. SUMMARY: Mechanical chest compression devices have been developed to better deliver uninterrupted chest compressions of good quality...
June 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26568325/load-distributing-band-cardiopulmonary-resuscitation-for-out-of-hospital-cardiac-arrest-increases-regional-cerebral-oxygenation-a-single-center-prospective-pilot-study
#4
COMPARATIVE STUDY
Yoshihito Ogawa, Tadahiko Shiozaki, Tomoya Hirose, Mitsuo Ohnishi, Yasushi Nakamori, Hiroshi Ogura, Takeshi Shimazu
BACKGROUND: Despite advances in therapeutic strategies and improved guidelines, morbidity and mortality rates for out-of-hospital cardiac arrest (OHCA) remain high. Especially, neurological prognosis is one of the most important problems even though brain protection therapy for patients with OHCA has improved greatly in recent years due to the development of emergency post-cardiac arrest interventions such as mild therapeutic hypothermia, early percutaneous coronary intervention, and extracorporeal cardiopulmonary resuscitation (CPR)...
November 14, 2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27318408/improving-survival-from-cardiac-arrest-a-review-of-contemporary-practice-and-challenges
#5
REVIEW
Jacob C Jentzer, Casey M Clements, R Scott Wright, Roger D White, Allan S Jaffe
Cardiac arrest is a common and lethal condition frequently encountered by emergency medicine providers. Resuscitation of persons after cardiac arrest remains challenging, and outcomes remain poor overall. Successful resuscitation hinges on timely, high-quality cardiopulmonary resuscitation. The optimal method of providing chest compressions and ventilator support during cardiac arrest remains uncertain. Prompt and effective defibrillation of ventricular arrhythmias is one of the few effective therapies available for treatment of cardiac arrest...
December 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26550795/trial-of-continuous-or-interrupted-chest-compressions-during-cpr
#6
RANDOMIZED CONTROLLED TRIAL
Graham Nichol, Brian Leroux, Henry Wang, Clifton W Callaway, George Sopko, Myron Weisfeldt, Ian Stiell, Laurie J Morrison, Tom P Aufderheide, Sheldon Cheskes, Jim Christenson, Peter Kudenchuk, Christian Vaillancourt, Thomas D Rea, Ahamed H Idris, Riccardo Colella, Marshal Isaacs, Ron Straight, Shannon Stephens, Joe Richardson, Joe Condle, Robert H Schmicker, Debra Egan, Susanne May, Joseph P Ornato
BACKGROUND: During cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest, the interruption of manual chest compressions for rescue breathing reduces blood flow and possibly survival. We assessed whether outcomes after continuous compressions with positive-pressure ventilation differed from those after compressions that were interrupted for ventilations at a ratio of 30 compressions to two ventilations. METHODS: This cluster-randomized trial with crossover included 114 emergency medical service (EMS) agencies...
December 3, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26493124/challenging-the-dogma-of-traumatic-cardiac-arrest-management-a-military-perspective
#7
REVIEW
J E Smith, S Le Clerc, P A F Hunt
Attempts to resuscitate patients in traumatic cardiac arrest (TCA) have, in the past, been viewed as futile. However, reported outcomes from TCA in the past five years, particularly from military series, are improving. The pathophysiology of TCA is different to medical causes of cardiac arrest, and therefore, treatment priorities may also need to be different. This article reviews recent literature describing the pathophysiology of TCA and describes how the military has challenged the assumption that outcome is universally poor in these patients...
December 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26475247/does-intubation-improve-outcomes-over-supraglottic-airways-in-adult-out-of-hospital-cardiac-arrest
#8
REVIEW
Jestin N Carlson, Henry E Wang
No abstract text is available yet for this article.
March 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26139060/cardiac-arrest-a-treatment-algorithm-for-emergent-invasive-cardiac-procedures-in-the-resuscitated-comatose-patient
#9
REVIEW
Tanveer Rab, Karl B Kern, Jacqueline E Tamis-Holland, Timothy D Henry, Michael McDaniel, Neal W Dickert, Joaquin E Cigarroa, Matthew Keadey, Stephen Ramee
Patients who are comatose after cardiac arrest continue to be a challenge, with high mortality. Although there is an American College of Cardiology Foundation/American Heart Association Class I recommendation for performing immediate angiography and percutaneous coronary intervention (when indicated) in patients with ST-segment elevation myocardial infarction, no guidelines exist for patients without ST-segment elevation. Early introduction of mild therapeutic hypothermia is an established treatment goal. However, there are no established guidelines for risk stratification of patients for cardiac catheterization and possible percutaneous coronary intervention, particularly in patients who have unfavorable clinical features in whom procedures may be futile and affect public reporting of mortality...
July 7, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/23454438/post-resuscitation-care-and-outcomes-of-out-of-hospital-cardiac-arrest-a-nationwide-propensity-score-matching-analysis
#10
Joo Yeong Kim, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Eui Jung Lee, Chang Bae Park, Seung Sik Hwang
OBJECTIVE: This study aimed to determine whether active post-resuscitation care (APRC) was associated with improved out-of-hospital cardiac arrest (OHCA) outcomes on a nationwide level. METHODS AND RESULTS: We used a national OHCA cohort database consisting of hospital and ambulance data. We included all survivors of OHCA, excluding patients with non-cardiac etiology, younger than 15 years, and with unknown outcomes, from (2008 to 2010). The APRC was defined when the OHCA patients received mild therapeutic hypothermia (MTH) or active cardiac care (ACC), such as intravenous thrombolysis, percutaneous coronary intervention, coronary artery bypass surgery, and pacemaker/implantable cardioverter defibrillator insertion, as well as routine intensive care; patients receiving conservative post-resuscitation care (CPRC) served as the other group...
August 2013: Resuscitation
https://www.readbyqxmd.com/read/26143159/gender-and-survival-after-sudden-cardiac-arrest-a-systematic-review-and-meta-analysis
#11
REVIEW
Wulfran Bougouin, Hazrije Mustafic, Eloi Marijon, Mohammad Hassan Murad, Florence Dumas, Anna Barbouttis, Patricia Jabre, Frankie Beganton, Jean-Philippe Empana, David S Celermajer, Alain Cariou, Xavier Jouven
BACKGROUND: Conflicting results exist regarding the impact of gender on early survival after sudden cardiac arrest (SCA). We aimed to assess the association between female gender and early SCA survival. METHODS: We searched Embase, MEDLINE, EBM Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (between 1948 and January 2014) for studies evaluating the association between gender and survival after SCA. Two independent reviewers selected studies of any design or language...
September 2015: Resuscitation
https://www.readbyqxmd.com/read/19130982/recent-advances-in-cardiopulmonary-resuscitation-cardiocerebral-resuscitation
#12
REVIEW
Gordon A Ewy, Karl B Kern
Cardiocerebral resuscitation (CCR) is a new approach for resuscitation of patients with cardiac arrest. It is composed of 3 components: 1) continuous chest compressions for bystander resuscitation; 2) a new emergency medical services (EMS) algorithm; and 3) aggressive post-resuscitation care. The first 2 components of CCR were first instituted in 2003 in Tucson, Arizona; in 2004 in the Rock and Walworth counties of Wisconsin; and in 2005 in the Phoenix, Arizona, metropolitan area. The CCR method has been shown to dramatically improve survival in the subset of patients most likely to survive: those with witnessed arrest and shockable rhythm on arrival of EMS...
January 13, 2009: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/25419698/outcomes-after-out-of-hospital-cardiac-arrest-treated-by-basic-vs-advanced-life-support
#13
COMPARATIVE STUDY
Prachi Sanghavi, Anupam B Jena, Joseph P Newhouse, Alan M Zaslavsky
IMPORTANCE: Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. OBJECTIVE: To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases)...
February 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/25238739/systematic-review-of-the-mechanisms-driving-effective-blood-flow-during-adult-cpr
#14
REVIEW
Marios Georgiou, Elizabeth Papathanassoglou, Theodoros Xanthos
BACKGROUND: High quality chest compressions is the most significant factor related to improved short-term and long-term outcome in cardiac arrest. However, considerable controversy exists over the mechanisms involved in driving blood flow. OBJECTIVES: The aim of this systematic review is to elucidate major mechanisms involved in effective compression-mediated blood flow during adult cardiopulmonary resuscitation (CPR). DESIGN AND SETTING: Systematic review of studies identified from the bibliographic databases of PubMed/Medline, Cochrane, and Scopus...
November 2014: Resuscitation
https://www.readbyqxmd.com/read/20370759/cardiocerebral-resuscitation-is-associated-with-improved-survival-and-neurologic-outcome-from-out-of-hospital-cardiac-arrest-in-elders
#15
COMPARATIVE STUDY
Jarrod Mosier, Ajit Itty, Arthur Sanders, Jane Mohler, Christopher Wendel, Jacob Poulsen, Jeff Shellenberger, Lani Clark, Bentley Bobrow
BACKGROUND: Recent studies have shown that a new emergency medical services (EMS) protocol for treating patients who suffer out-of-hospital cardiac arrest (OHCA), cardiocerebral resuscitation (CCR), significantly improves survival compared to standard advanced life support (ALS). However, due to their different physiology, it is unclear if all elders, or any subsets of elders who are OHCA victims, would benefit from the CCR protocol. OBJECTIVES: The objectives of this analysis were to compare survival by age group for patients receiving CCR and ALS, to evaluate their neurologic outcome, and to determine what other factors affect survival in the subset of patients who do receive CCR...
March 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/25077491/cardiocerebral-resuscitation-an-approach-to-improving-survival-of-patients-with-primary-cardiac-arrest
#16
REVIEW
Gordon A Ewy, Bentley J Bobrow
Out-of-hospital cardiac arrest (OHCA) is a major public health problem. In the United States, OHCA accounts for more premature deaths than any other cause. For over a half-century, the national "Guidelines" for resuscitation have recommended the same initial treatment of primary and secondary cardiac arrests. Using this approach, the overall survival of patients with OHCA, while quite variable, was generally very poor. One reason is that the etiologies of cardiac arrests are not all the same. The vast majority of nontraumatic OHCA in adults are due to a "primary" cardiac arrest, rather than secondary to respiratory arrest...
January 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/23992943/does-calcium-administration-during-cardiopulmonary-resuscitation-improve-survival-for-patients-in-cardiac-arrest
#17
EDITORIAL
Adaira Landry, Mark Foran, Alex Koyfman
No abstract text is available yet for this article.
August 2014: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/20935561/multicenter-cohort-study-of-out-of-hospital-pediatric-cardiac-arrest
#18
MULTICENTER STUDY
Frank W Moler, Amy E Donaldson, Kathleen Meert, Richard J Brilli, Vinay Nadkarni, Donald H Shaffner, Charles L Schleien, Robert S B Clark, Heidi J Dalton, Kimberly Statler, Kelly S Tieves, Richard Hackbarth, Robert Pretzlaff, Elise W van der Jagt, Jose Pineda, Lynn Hernan, J Michael Dean
OBJECTIVES: To describe a large cohort of children with out-of-hospital cardiac arrest with return of circulation and to identify factors in the early postarrest period associated with survival. These objectives were for planning an interventional trial of therapeutic hypothermia after pediatric cardiac arrest. METHODS: A retrospective cohort study was conducted at 15 Pediatric Emergency Care Applied Research Network clinical sites over an 18-month study period...
January 2011: Critical Care Medicine
https://www.readbyqxmd.com/read/24297818/pulseless-electric-activity-definition-causes-mechanisms-management-and-research-priorities-for-the-next-decade-report-from-a-national-heart-lung-and-blood-institute-workshop
#19
REVIEW
Robert J Myerburg, Henry Halperin, Debra A Egan, Robin Boineau, Sumeet S Chugh, Anne M Gillis, Joshua I Goldhaber, David A Lathrop, Peter Liu, James T Niemann, Joseph P Ornato, George Sopko, Jennifer E Van Eyk, Gregory P Walcott, Myron L Weisfeldt, Jacqueline D Wright, Douglas P Zipes
No abstract text is available yet for this article.
December 3, 2013: Circulation
https://www.readbyqxmd.com/read/23956861/maternal-cardiac-arrest-a-practical-and-comprehensive-review
#20
Farida M Jeejeebhoy, Laurie J Morrison
Cardiac arrest during pregnancy is a dedicated chapter in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; however, a robust maternal cardiac arrest knowledge translation strategy and emergency response plan is not usually the focus of institutional emergency preparedness programs. Although maternal cardiac arrest is rare, the emergency department is a high-risk area for receiving pregnant women in either prearrest or full cardiac arrest. It is imperative that institutions review and update emergency response plans for a maternal arrest...
2013: Emergency Medicine International
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