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"Advanced Life Support" OR "ALS" OR "Advanced Cardiac Life Support" OR "ACLS"

T Luiz, H Marung, G Pollach, A Hackstein
BACKGROUND: The emergency call-taking process is crucial for the adequate disposition of emergency vehicles and the provision of first aid instructions. Moreover, it has a direct impact on the quality of out-of-hospital emergency care. Organizations such as the European Resuscitation Council, the German Federal Association of Emergency Medical Directors and the German Association of Emergency Dispatch Centers call for the nationwide implementation of a formal call-taking process in emergency dispatching...
March 21, 2019: Der Anaesthesist
Daniel Hakakian, Karen Kong, Dorian Atanas Bogdanovski, Andrew Benvenuto, Louis Thomas DiFazio, Renay Durling-Grover, Rolando Hector Rolandelli, Zoltan H Nemeth
INTRODUCTION: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. SETTING: Morristown Medical Center (MMC), Morristown, NJ METHODS: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed...
March 2019: Air Medical Journal
Zachary Laksman, Scott Barichello, Thomas M Roston, Marc W Deyell, Andrew D Krahn
After the most common causes of sudden cardiac death including ischemic and structural heart disease have been ruled out, clinicians on the front lines of emergent medical care can be faced with unexplained and recurrent life-threatening arrhythmia episodes in children and adults. In these cases, an inherited arrhythmia syndrome should be suspected, and a departure from conventional advanced cardiac life support algorithms may be required. This review focuses on the electrocardiographic clues of an inherited arrhythmia syndrome that can be uncovered through a careful analysis of the baseline electrocardiogram (ECG) and classification of the presenting ventricular arrhythmia and its mode of onset...
March 2019: JACC. Clinical Electrophysiology
Takahiro Nakashima, Teruo Noguchi, Yoshio Tahara, Kunihiro Nishimura, Soshiro Ogata, Satoshi Yasuda, Daisuke Onozuka, Naoto Morimura, Ken Nagao, David F Gaieski, Yasufumi Asai, Hiroyuki Yokota, Satoshi Nara, Mamoru Hase, Takahiro Atsumi, Tetsuya Sakamoto
BACKGROUND: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) and sustained ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) or conversion to pulseless electrical activity/asystole (PEA/asystole) benefit more from extracorporeal cardiopulmonary resuscitation (ECPR). Methods and Results: We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, which was a prospective, multicenter, observational study with 22 institutions in the ECPR group and 17 institutions in the conventional CPR (CCPR) group...
March 20, 2019: Circulation Journal: Official Journal of the Japanese Circulation Society
Harendra Kumara, Nimal Seneviratne, Dilini S Jayaratne, Sisira Siribaddana, Geoffrey K Isbister, Anjana Silva
The Merrem's hump-nosed viper (H. hypnale) causes many snakebites in South India and Sri Lanka. At present no antivenom is available for envenomings by this snake. A 42-year-old male bitten by a large H. hypnale, presented within 30 min of the bite and had a cardiac arrest soon after admission. This responded to standard advanced life support, but he had an unrecordably high international normalised ratio (INR), activated partial thromboplastin time and unrecordably low fibrinogen, consistent with a complete venom-induced consumption coagulopathy...
March 15, 2019: Toxicon: Official Journal of the International Society on Toxinology
Charles W Hwang, Ginger Gamble, Michael Marchick, Torben K Becker
Current advanced cardiac life support (ACLS) guidelines for the management of ventricular fibrillation (VF) and pulseless ventricular tachycardia is defibrillation. However, refractory VF, which is defined as VF that persists despite three defibrillation attempts, is challenging for all ACLS providers; the best resuscitation strategy for patients that persist in refractory VF remains unclear. We report on a 51-year-old man who presented to the emergency department with chest pain and subsequently went into witnessed VF cardiac arrest...
March 8, 2019: BMJ Case Reports
Linda Nancy Roney, Mary C Acri
The significance of nursing competence in the care of pediatric trauma patients has been well documented. Continuing education for trauma nurses is a critical component of maintaining competence in pediatric trauma care; yet, there is significant variability in the programs and resources used to support this goal. The purpose of this current study was to describe the educational activities that practicing registered nurses engage in to inform their care of injured children. A quantitative, descriptive nonexperimental research design was utilized to describe the educational programs that members of the Society of Trauma Nurses (STN) must complete to work in verified and designated trauma centers...
March 2019: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Diana Cimpoesu, Mihaela Corlade-Andrei, Tudor Ovidiu Popa, Gabriela Grigorasi, Catalin Bouros, Luciana Rotaru, Paul Lucian Nedelea
BACKGROUND: Cardiopulmonary resuscitation (CPR) in special circumstances includes the emergency intervention for special causes, special environments, and special patients. Special causes cover the potential reversible causes of cardiac arrest that must be identified or excluded during any resuscitation act. The special environments section includes recommendations for the treatment of cardiac arrest occurring in specific locations: cardiac surgery, catheterization laboratory, dialysis unit, dental surgery, commercial airplanes or air ambulances, playing field, difficult environment (eg, drowning, high altitude, avalanche, and electrical injuries) or mass casualty incident...
March 2019: American Journal of Therapeutics
Gandhi Lanke, Douglas G Adler
Air embolism is rarely diagnosed and is often fatal. The diagnosis is often not made in a timely manner given the rapid and severe clinical deterioration that often develops, frequently leading to cardiac arrest. Many patients are only diagnosed post-mortem. With the increasing use of endoscopic retrograde cholangiopancreatography, air embolism should be considered in the differential diagnosis in patients who experience sudden clinical deterioration during or immediately after the procedure. Clinical suspicion is key in the diagnosis and management of air embolism...
March 2019: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Summer Powers, Nancy Claus, Allison R Jones, Michael R Lovelace, Kendra Weaver, Penni Watts
BACKGROUND: Nursing students often lack the skills and confidence to intervene in the care of a deteriorating patient as they transition into clinical practice. Exposure to these situations is limited during their academic career. Our team sought to address this by embedding American Heart Association (AHA) advanced cardiac life support (ACLS) content into the curriculum and offering certification to senior-level students. METHOD: The senior skills course was redesigned to include education on current AHA ACLS guidelines and skills...
March 1, 2019: Journal of Nursing Education
Kap Su Han, Su Jin Kim, Eui Jung Lee, Jae Seung Jung, Jae Hyoung Park, Sung Woo Lee
INTRODUCTION: Extracorporeal cardiopulmonary resuscitation (ECPR) is a method to improve survival outcomes in refractory cardiac arrest. HYPOTHESIS: This study aimed to determine the associated factors related to outcome and to analyse the post-ECPR management in patients who received ECPR due to non-response to advanced cardiac life support (ACLS). METHODS: This was a retrospective analysis based on a prospective cohort. Cardiac arrest patients who received ECPR in our emergency department from May 2006 to December 2017 were selected from the prospective cohort...
February 28, 2019: Clinical Cardiology
Patrick Sulzgruber, Sebastian Schnaubelt, Marco Pesce, Thomas Uray, Jan Niederdöckl, Hans Domanovits, Raphael Rosenheck, Thomas Binder, Klaus Distelmaier, Christian Hengstenberg, Alexander Niessner, Georg Goliasch
BACKGROUND: Prognostic tools for decision-making whether to continue advanced life support or limit life sustaining interventions in In-Hospital Cardiac Arrest (IHCA), remain scarce and inconclusive. In this regard it seems intuitive that the presence of aortic stenosis (AS) impacts on both central and peripheral perfusion during resuscitative attempts and might worsen outcome. Therefore, we aimed to investigate the prognostic value of AS on outcome after IHCA. METHODS: Out of 11,641 patients presenting with acute coronary syndrome, a total of 151 patients were identified that received a standardized echocardiographic diagnostic immediately prior to an IHCA...
February 25, 2019: Resuscitation
Vishal H Patel, Philip Vendittelli, Rajat Garg, Susan Szpunar, Thomas LaLonde, John Lee, Howard Rosman, Rajendra H Mehta, Hussein Othman
BACKGROUND: In-hospital cardiac arrest (IHCA) portends a poor prognosis and survival to discharge rate. Prognostic markers such as interleukin-6, S-100 protein and high sensitivity C reactive protein have been studied as predictors of adverse outcomes after return of spontaneous circulation (ROSC); however; these variables are not routine laboratory tests and incur additional cost making them difficult to incorporate and less attractive in assessing patient's prognosis. The neutrophil-lymphocyte ratio (NLR) is a marker of adverse prognosis for many cardiovascular conditions and certain types of cancers and sepsis...
February 21, 2019: World Journal of Critical Care Medicine
Fahad AlSohime, Akram NurHussen, Mohamad-Hani Temsah, Majed Alabdulhafez, Ayman Al-Eyadhy, Gamal M Hasan, Abdullah Al-Huzaimi, Abdulrahman AlKanhal, Deemah Almanie
Objective: The leadership skills of pediatric residents during cardiopulmonary resuscitation (CPR) may have major impacts on their performance. These skills should be addressed during the pediatric residency training program. Therefore, we aimed to identify the perceptions of residents regarding their level of confidence in providing or leading a real pediatric CPR code, and to identify different factors that might influence their self-confidence when assuming the role of a team leader during a real CPR...
September 2018: International Journal of Pediatrics & Adolescent Medicine
Peter Mair, Lukas Gasteiger, Birgit Mair, Mathias Stroehle, Beat Walpoth
Mair, Peter, Lukas Gasteiger, Birgit Mair, Mathias Stroehle, and Beat Walpoth. Successful defibrillation of four hypothermic patients with witnessed cardiac arrest. BACKGROUND: Because of the limited evidence available, recommendations for defibrillation of hypothermic patients vary among published guidelines. AIM: To report successful defibrillation of four severely hypothermic patients with witnessed cardiac arrest. RESULTS: During a four-year period from 2014 to 2017, four of five hypothermic patients admitted to our institution with a history of sudden, unexpected ventricular fibrillation (core temperature: 24°C-27°C) were successfully defibrillated...
February 25, 2019: High Altitude Medicine & Biology
Stacie B Peddy
Introduction: Cardiopulmonary compromises are infrequent but high-acuity events that occur at pediatric hospitals. Simulation is a powerful modality to teach fellows in pediatric critical care, cardiology, and neonatology important clinical skills in managing complex cardiorespiratory pathophysiology in infants with cyanotic heart disease. Methods: We developed three simulation cases of hypoxemia involving differing complex cardiorespiratory pathophysiology in neonates/infants with cyanotic heart disease...
April 17, 2018: MedEdPORTAL Publications
Yoonje Lee, Hyungoo Shin, Hyuk Joong Choi, Changsun Kim
OBJECTIVE: The purpose of this study was to assess whether a photoplethysmography (PPG) sensor in a smart watch can accurately recognise the return of spontaneous circulation (ROSC) in cardiac arrest patients compared with carotid artery palpation. METHODS: This prospective observational study was conducted on 50 out-of-hospital cardiac arrest patients who visited the emergency department (ED) of one tertiary hospital. As soon as the patient arrived at the ED, advanced cardiac life support was carried out immediately...
February 19, 2019: BMJ Open
Subhas Sitaula, Pratibha Kaul, Vikram Aggarwal
Sudden cardiac death (SCD) is reported as leading cause of death in patients on chronic hemodialysis. Arrhythmias are proposed to be a major predisposing factor for SCD. However, triggers for potentially lethal arrhythmias are not well understood. Here we describe a case of 72-year-old man on chronic hemodialysis via permanent Central venous catheter (CVC) who was admitted for evaluation after unwitnessed fall. Within 10 minutes of his first routine dialysis session in the hospital, he had cardiac-arrest. He was successfully resuscitated within 3 minutes...
February 18, 2019: Hemodialysis International
Gunnar Waage Skjeflo, Eirik Skogvoll, Jan Pål Loennechen, Theresa Mariero Olasveengen, Lars Wik, Trond Nordseth
INTRODUCTION: Presence of electrocardiographic rhythm in the absence of palpable pulses defines pulseless electrical activity (PEA) and the electrocardiogram (ECG) may provide a source of information during resuscitation. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) from Out-of-Hospital-Cardiac-Arrest (OHCA) with initial PEA, and to explore the potential effects of adrenaline on these characteristics. METHODS: Patients with OHCA and initial PEA, part of randomized controlled trial of ALS with or without intravenous access and medications, were included...
January 29, 2019: Resuscitation
Paul R Atkinson, Andrew W Keyes, Kathleen O'Donnell, Nicole Beckett, Ankona Banerjee, Jacqueline Fraser, David Lewis
Introduction Electrocardiographic (ECG) rhythms are used during advanced cardiac life support (ACLS) to guide resuscitation management. Survival to hospital discharge has been reported to be better for patients with pulseless electrical activity (PEA) than asystole in out-of-hospital arrests. Despite this, treatment for these two (non-shockable) rhythms is combined in ACLS guidelines. This study examines if the recorded cardiac rhythm of asystole or PEA during ACLS accurately predicts mechanical cardiac activity as determined by point-of-care ultrasound (PoCUS)...
November 23, 2018: Curēus
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