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Cardiac arrest

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By Richard Gough Paramedic tutor, Post Qualification Manager
https://www.readbyqxmd.com/read/27650864/pre-hospital-assessment-of-the-role-of-adrenaline-measuring-the-effectiveness-of-drug-administration-in-cardiac-arrest-paramedic-2-trial-protocol
#1
Gavin D Perkins, Tom Quinn, Charles D Deakin, Jerry P Nolan, Ranjit Lall, Anne-Marie Slowther, Matthew Cooke, Sarah E Lamb, Stavros Petrou, Felix Achana, Judith Finn, Ian G Jacobs, Andrew Carson, Mike Smyth, Kyee Han, Sonia Byers, Nigel Rees, Richard Whitfield, Fionna Moore, Rachael Fothergill, Nigel Stallard, John Long, Susie Hennings, Jessica Horton, Charlotte Kaye, Simon Gates
Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/23484827/family-presence-during-cardiopulmonary-resuscitation
#2
RANDOMIZED CONTROLLED TRIAL
Patricia Jabre, Vanessa Belpomme, Elie Azoulay, Line Jacob, Lionel Bertrand, Frederic Lapostolle, Karim Tazarourte, Guillem Bouilleau, Virginie Pinaud, Claire Broche, Domitille Normand, Thierry Baubet, Agnes Ricard-Hibon, Jacques Istria, Alexandra Beltramini, Armelle Alheritiere, Nathalie Assez, Lionel Nace, Benoit Vivien, Laurent Turi, Stephane Launay, Michel Desmaizieres, Stephen W Borron, Eric Vicaut, Frederic Adnet
BACKGROUND: The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. METHODS: We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group)...
March 14, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/26095301/time-on-the-scene-and-interventions-are-associated-with-improved-survival-in-pediatric-out-of-hospital-cardiac-arrest
#3
MULTICENTER STUDY
Janice A Tijssen, David K Prince, Laurie J Morrison, Dianne L Atkins, Michael A Austin, Robert Berg, Siobhan P Brown, Jim Christenson, Debra Egan, Preston J Fedor, Ericka L Fink, Garth D Meckler, Martin H Osmond, Kathryn A Sims, James S Hutchison
BACKGROUND: Survival is less than 10% for pediatric patients following out-of-hospital cardiac arrest. It is not known if more time on the scene of the cardiac arrest and advanced life support interventions by emergency services personnel are associated with improved survival. AIM: This study was performed to determine which times on the scene and which prehospital interventions were associated with improved survival. METHODS: We studied patients aged 3 days to 19 years old with out-of-hospital cardiac arrest, using the Resuscitation Outcomes Consortium cardiac arrest database from 11 North American regions, from 2005 to 2012...
September 2015: Resuscitation
https://www.readbyqxmd.com/read/25567065/outcome-following-physician-supervised-prehospital-resuscitation-a-retrospective-study
#4
Søren Mikkelsen, Andreas J Krüger, Stine T Zwisler, Anne C Brøchner
BACKGROUND: Prehospital care provided by specially trained, physician-based emergency services (P-EMS) is an integrated part of the emergency medical systems in many developed countries. To what extent P-EMS increases survival and favourable outcomes is still unclear. The aim of the study was thus to investigate ambulance runs initially assigned 'life-saving missions' with emphasis on long-term outcome in patients treated by the Mobile Emergency Care Unit (MECU) in Odense, Denmark METHODS: All MECU runs are registered in a database by the attending physician, stating, among other parameters, the treatment given, outcome of the treatment and the patient's diagnosis...
January 7, 2015: BMJ Open
https://www.readbyqxmd.com/read/25552890/the-scene-time-interval-and-basic-life-support-termination-of-resuscitation-rule-in-adult-out-of-hospital-cardiac-arrest
#5
Tae Han Kim, Sang Do Shin, Yu Jin Kim, Chu Hyun Kim, Jeong Eun Kim
We validated the basic life support termination of resuscitation (BLS TOR) rule retrospectively using Out-of-Hospital Cardiac Arrest (OHCA) data of metropolitan emergency medical service (EMS) in Korea. We also tested it by investigating the scene time interval for supplementing the BLS TOR rule. OHCA database of Seoul (January 2011 to December 2012) was used, which is composed of ambulance data and hospital medical record review. EMS-treated OHCA and 19 yr or older victims were enrolled, after excluding cases occurred in the ambulance and with incomplete information...
January 2015: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/25493114/does-pre-hospital-endotracheal-intubation-improve-survival-in-adults-with-non-traumatic-out-of-hospital-cardiac-arrest-a-systematic-review
#6
REVIEW
Ling Tiah, Kentaro Kajino, Omer Alsakaf, Dianne Carrol Tan Bautista, Marcus Eng Hock Ong, Desiree Lie, Ghulam Yasin Naroo, Nausheen Edwin Doctor, Michael Y C Chia, Han Nee Gan
INTRODUCTION: Endotracheal intubation (ETI) is currently considered superior to supraglottic airway devices (SGA) for survival and other outcomes among adults with non-traumatic out-of-hospital cardiac arrest (OHCA). We aimed to determine if the research supports this conclusion by conducting a systematic review. METHODS: We searched the MEDLINE, Scopus and CINAHL databases for studies published between January 1, 1980, and 30 April 30, 2013, which compared pre-hospital use of ETI with SGA for outcomes of return of spontaneous circulation (ROSC); survival to hospital admission; survival to hospital discharge; and favorable neurological or functional status...
November 2014: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25468877/prehospital-use-of-adrenaline-reduces-survival-in-cardiac-arrest-study-finds
#7
COMMENT
Susan Mayor
No abstract text is available yet for this article.
2014: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/25467566/mechanical-versus-manual-chest-compression-for-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Gavin D Perkins, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Richard Whitfield, Amanda Williams, Helen Pocock, John J M Black, John Wright, Kyee Han, Simon Gates
BACKGROUND: Mechanical chest compression devices have the potential to help maintain high-quality cardiopulmonary resuscitation (CPR), but despite their increasing use, little evidence exists for their effectiveness. We aimed to study whether the introduction of LUCAS-2 mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest. METHODS: The pre-hospital randomised assessment of a mechanical compression device in cardiac arrest (PARAMEDIC) trial was a pragmatic, cluster-randomised open-label trial including adults with non-traumatic, out-of-hospital cardiac arrest from four UK Ambulance Services (West Midlands, North East England, Wales, South Central)...
March 14, 2015: Lancet
https://www.readbyqxmd.com/read/25182381/effectiveness-of-prehospital-magill-forceps-use-for-out-of-hospital-cardiac-arrest-due-to-foreign-body-airway-obstruction-in-osaka-city
#9
Tomohiko Sakai, Tetsuhisa Kitamura, Taku Iwami, Chika Nishiyama, Kayo Tanigawa-Sugihara, Sumito Hayashida, Tatsuya Nishiuchi, Kentaro Kajino, Taro Irisawa, Tadahiko Shiozaki, Hiroshi Ogura, Osamu Tasaki, Yasuyuki Kuwagata, Atsushi Hiraide, Takeshi Shimazu
BACKGROUND: Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO...
2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/25128949/cardiopulmonary-resuscitation-time-for-a-change-in-the-paradigm
#10
Michele Levinson, Amber Mills
Cardiopulmonary resuscitation (CPR) is the default treatment in hospital unless there is a decision to the contrary and this is documented in the patient record. The outcome of CPR in older chronically ill patients is very poor and discharge home is unlikely. Fewer not-for-resuscitation (NFR) orders are written than there are patients who would not benefit from CPR. NFR orders appear to be a marker of death, rather than the result of informed discussion about end-of-life care. There is a legal and ethical framework for the consideration of the suitability of CPR...
August 4, 2014: Medical Journal of Australia
https://www.readbyqxmd.com/read/25147363/one-handed-chest-compression-technique-for-paediatric-cardiopulmonary-resuscitation-dominant-versus-non-dominant-hand
#11
RANDOMIZED CONTROLLED TRIAL
Je Hyeok Oh, Chan Woong Kim, Sung Eun Kim, Dong Hoon Lee, Sang Jin Lee
BACKGROUND: Pediatric resuscitation guidelines do not specify which hand to use for one-handed cardiopulmonary resuscitation (CPR). OBJECTIVE: To determine whether there is a difference in the quality of one-handed chest compressions (OHCCs) using the dominant versus non-dominant hand in simulated paediatric CPR. MATERIALS AND METHODS: 41 doctors took part in the study. Chest compressions were alternately performed with the dominant (test 1) and non-dominant hand (test 2) in a random order at 30 min intervals...
July 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25125530/the-shocking-truth-time-between-defibrillation-attempts-during-pre-hospital-resuscitation-of-vf-cardiac-arrest
#12
Kirsty Mitchell, Steven Short, Gareth Clegg
OBJECTIVES & BACKGROUND: Timely defibrillation and high-quality cardiopulmonary resuscitation (CPR) are the only pre-hospital interventions which have been demonstrated to save lives after OHCA (out-of-hospital cardiac arrest). Standard resuscitation using the advanced life support (ALS) algorithm specifies a period of two minutes of CPR after delivering a shock before re-assessing the rhythm and delivering a further shock if indicated. Recent work has focused on improving quality of CPR, but few studies have examined how effectively defibrillation is carried out in pre-hospital practice...
September 2014: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25096597/half-of-ambulance-trusts-have-no-record-of-terminally-ill-patients-end-of-life-wishes
#13
Gareth Iacobucci
No abstract text is available yet for this article.
2014: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/25079607/effects-of-prehospital-adrenaline-administration-on-out-of-hospital-cardiac-arrest-outcomes-a-systematic-review-and-meta-analysis
#14
REVIEW
Pongsakorn Atiksawedparit, Sasivimol Rattanasiri, Mark McEvoy, Colin A Graham, Yuwares Sittichanbuncha, Ammarin Thakkinstian
INTRODUCTION: The aim of this study was to conduct a systematic review and meta-analysis for determining the effects of prehospital adrenaline administration on return of spontaneous circulation, hospital admission, survival to discharge and discharge with cerebral performance category 1 or 2 in out-of-hospital cardiac arrest patients. METHODS: MEDLINE and Scopus databases were searched to identify studies reported to March 2014. Study selection and data extraction were independently completed by two reviewers (PA and SR)...
July 31, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/24326888/adrenaline-for-out-of-hospital-cardiac-arrest
#15
EDITORIAL
Theresa Mariero Olasveengen
No abstract text is available yet for this article.
2013: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/24709574/is-adrenaline-safe-and-effective-as-a-treatment-for-out-of-hospital-cardiac-arrest
#16
Gavin D Perkins, Peter Cottrell, Simon Gates
No abstract text is available yet for this article.
2014: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/24874448/early-adrenaline-for-cardiac-arrest
#17
EDITORIAL
Gavin D Perkins, Jerry P Nolan
No abstract text is available yet for this article.
2014: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/24326886/evaluation-of-pre-hospital-administration-of-adrenaline-epinephrine-by-emergency-medical-services-for-patients-with-out-of-hospital-cardiac-arrest-in-japan-controlled-propensity-matched-retrospective-cohort-study
#18
Shinji Nakahara, Jun Tomio, Hideto Takahashi, Masao Ichikawa, Masamichi Nishida, Naoto Morimura, Tetsuya Sakamoto
OBJECTIVES: To evaluate the effectiveness of pre-hospital adrenaline (epinephrine) administered by emergency medical services to patients with out of hospital cardiac arrest. DESIGN: Controlled propensity matched retrospective cohort study, in which pairs of patients with or without (control) adrenaline were created with a sequential risk set matching based on time dependent propensity score. SETTING: Japan's nationwide registry database of patients with out of hospital cardiac arrest registered between January 2007 and December 2010...
2013: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/21745533/effect-of-adrenaline-on-survival-in-out-of-hospital-cardiac-arrest-a-randomised-double-blind-placebo-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Ian G Jacobs, Judith C Finn, George A Jelinek, Harry F Oxer, Peter L Thompson
BACKGROUND: There is little evidence from clinical trials that the use of adrenaline (epinephrine) in treating cardiac arrest improves survival, despite adrenaline being considered standard of care for many decades. The aim of our study was to determine the effect of adrenaline on patient survival to hospital discharge in out of hospital cardiac arrest. METHODS: We conducted a double blind randomised placebo-controlled trial of adrenaline in out-of-hospital cardiac arrest...
September 2011: Resuscitation
https://www.readbyqxmd.com/read/24252433/neurological-outcomes-in-patients-transported-to-hospital-without-a-prehospital-return-of-spontaneous-circulation-after-cardiac-arrest
#20
Yoshikazu Goto, Tetsuo Maeda, Yumiko Nakatsu-Goto
INTRODUCTION: As emergency medical services (EMS) personnel in Japan are not allowed to perform termination of resuscitation in the field, most patients experiencing an out-of-hospital cardiac arrest (OHCA) are transported to hospitals without a prehospital return of spontaneous circulation (ROSC). As the crucial prehospital factors for outcomes are not clear in patients who had an OHCA without a prehospital ROSC, we aimed to determine the prehospital factors associated with 1-month favorable neurological outcomes (Cerebral Performance Category scale 1 or 2 (CPC 1-2))...
2013: Critical Care: the Official Journal of the Critical Care Forum
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