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Cardiac arrest transport

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https://read.qxmd.com/read/30723506/cardiac-arrest-in-the-airport-revealing-cocaine-body-packing-a-case-report
#1
Dabor Resiere, Hossein Mehdaoui, Bruno Megarbane
Ingestion of large amounts of cocaine packages is a well-known method for cross-border transportation. Intestinal obstruction and life-threatening sympathomimetic toxidrome including seizures, ventricular dysrhythmia, and cardiac arrest resulting from the rupture of cocaine packages may occur. Here, we report a case of a 34-year-old pregnant woman who had a sudden cardiac arrest while waiting for her bags at Paris-Charles de Gaulle Airport, France. According to the flight attendants, the patient travelled from Brazil and complained of abdominal pain during the flight...
2019: Case Reports in Medicine
https://read.qxmd.com/read/30720392/palliative-care-in-paramedic-practice-a-retrospective-cohort-study
#2
Bill Lord, Emily Andrew, Amanda Henderson, David J Anderson, Karen Smith, Stephen Bernard
BACKGROUND: Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic's role in the care of these patients. AIM: To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. DESIGN: This is a retrospective cohort study. SETTING/PARTICIPANTS: Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record...
February 5, 2019: Palliative Medicine
https://read.qxmd.com/read/30683057/cluster-randomised-comparison-of-the-effectiveness-of-100-oxygen-versus-titrated-oxygen-in-patients-with-a-sustained-return-of-spontaneous-circulation-following-out-of-hospital-cardiac-arrest-a-feasibility-study-proxy-post-rosc-oxygenation-study
#3
Matthew Thomas, Sarah Voss, Jonathan Benger, Kim Kirby, Jerry P Nolan
BACKGROUND: Hyperoxia following out of hospital cardiac arrest (OHCA) is associated with a poor outcome. Animal data suggest the first hour post resuscitation may be the most important. In the UK the first hour usually occurs in the prehospital environment. METHODS: A prospective controlled trial, cluster randomised by paramedic, comparing titrated oxygen with 100% oxygen for the first hour after return of spontaneous circulation (ROSC) following OHCA. The trial was done in a single emergency medical services (EMS) system in the United Kingdom (UK) admitting patients to three emergency departments...
January 25, 2019: BMC Emergency Medicine
https://read.qxmd.com/read/30682388/hydrogen-sulfide-preconditioning-could-ameliorate-reperfusion-associated-injury-in-diabetic-cardiomyopathy-rat-heart-through-preservation-of-mitochondria
#4
Mahalakshmi Ansari, Gino A Kurian
Evidence suggests that hydrogen sulfide precondition (HIPC) is an effective protocol in the management of ischemia reperfusion (I/R) by attenuating free radical and calcium overload in mitochondria. However the efficacy of HIPC is largely unknown in diabetic cardiomyopathy (DCM) hearts subjected to I/R procedure. Male Wistar rats were randomly divided into three groups: i) normal, ii) diabetes mellitus (DM), and iii) diabetic cardiomyopathy (DCM). DM and DCM animals were prepared by using streptozotocin injection at the age of 4 week (35mg/kg, i...
January 22, 2019: Biochimie
https://read.qxmd.com/read/30654012/the-acute-respiratory-distress-syndrome-after-out-of-hospital-cardiac-arrest-incidence-risk-factors-and-outcomes
#5
Nicholas J Johnson, Ellen Caldwell, David J Carlbom, David F Gaieski, Matthew E Prekker, Thomas D Rea, Michael Sayre, Catherine L Hough
OBJECTIVE: To define the incidence of the acute respiratory distress syndrome (ARDS) following out-of-hospital cardiac arrest (OHCA) and characterize its impact on outcome. METHODS: This was a retrospective cohort study conducted at two urban, tertiary, academic hospitals from 2007 to 2014. We included adults with non-traumatic OHCA and survived for ≥48 h. Patients who received mechanical ventilation for ≥24 h, had 2 consecutive arterial blood gases with a ratio of the partial pressure of oxygen to the fraction of inspired oxygen ≤300, and bilateral radiographic opacities within 48 h of hospital admission were defined as having ARDS...
January 14, 2019: Resuscitation
https://read.qxmd.com/read/30646394/a-us-national-study-of-the-association-between-income-and-ambulance-response-time-in-cardiac-arrest
#6
Renee Y Hsia, Delphine Huang, N Clay Mann, Christopher Colwell, Mary P Mercer, Mengtao Dai, Matthew J Niedzwiecki
Importance: Emergency medical services (EMS) provide critical prehospital care, and disparities in response times to time-sensitive conditions, such as cardiac arrest, may contribute to disparities in patient outcomes. Objectives: To investigate whether ambulance 9-1-1 times were longer in low-income vs high-income areas and to compare response times with national benchmarks of 4, 8, or 15 minutes across income quartiles. Design, Setting, and Participants: A retrospective cross-sectional study was performed of the 2014 National Emergency Medical Services Information System data in June 2017 using negative binomial and logistic regressions to examine the association between zip code-level income and EMS response times...
November 2, 2018: JAMA network open
https://read.qxmd.com/read/30624426/craniocervical-dissociation-in-pediatric-patients-pearls-and-pitfalls-of-diagnosis-and-management
#7
Rajaie Hazboun, Amanda Muñoz, Paul R Krafft, Sheri Harder, Rosemary Vannix, Alexander Zouros, Paggie Kim, Joanne Baerg
AIMS: The aims of this study were to document the injury pattern in pediatric traumatic craniocervical dissociation (CCD) and identify features of survivors. METHODS: Pediatric traumatic CCDs, diagnosed between January 2004 and July 2016, were reviewed. Survivors and nonsurvivors were compared. Categorical and continuous variables were analyzed with Fisher exact and t tests, respectively. RESULTS: Twenty-seven children were identified; 10 died (37%)...
January 7, 2019: Pediatric Emergency Care
https://read.qxmd.com/read/30596310/improving-care-of-stemi-in-the-united-states-2008-to-2012
#8
Christopher B Granger, Eric R Bates, James G Jollis, Elliott M Antman, Graham Nichol, Robert E O'Connor, Tammy Gregory, Mayme L Roettig, S Andrew Peng, Gray Ellrodt, Timothy D Henry, William J French, Alice K Jacobs
Background We aimed to determine the change in treatment strategies and times to treatment over the first 5 years of the Mission: Lifeline program. Methods and Results We assessed pre- and in-hospital care and outcomes from 2008 to 2012 for patients with ST -segment-elevation myocardial infarction at US hospitals, using data from the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines Registry. In-hospital adjusted mortality was calculated including and excluding cardiac arrest as a reason for primary percutaneous coronary intervention delay...
January 8, 2019: Journal of the American Heart Association
https://read.qxmd.com/read/30591087/emergency-medical-services-experience-with-barb-removal-after-taser-use-by-law-enforcement-a-descriptive-national-study
#9
Mazen El Sayed, Chady El Tawil, Hani Tamim, Aurelie Mailhac, N Clay Mann
BACKGROUND: Conducted electrical weapons (CEWs), including Thomas A. Swift Electric Rifles (TASERs), are increasingly used by law enforcement officers (LEOs) in the US and world-wide. Little is known about the experience of Emergency Medical Service (EMS) providers with these incidents. OBJECTIVES: This study describes EMS encounters with documented TASER use and barb removal, characteristics of resulting injuries, and treatment provided. METHODS: This retrospective study used five combined, consecutive National Emergency Medical Services Information System (NEMSIS; Salt Lake City, Utah USA) public-release datasets (2011-2015)...
December 28, 2018: Prehospital and Disaster Medicine
https://read.qxmd.com/read/30590977/lucas-versus-manual-chest-compression-during-ambulance-transport-a-hemodynamic-study-in-a-porcine-model-of-cardiac-arrest
#10
Aurora Magliocca, Davide Olivari, Daria De Giorgio, Davide Zani, Martina Manfredi, Antonio Boccardo, Alberto Cucino, Giulia Sala, Giovanni Babini, Laura Ruggeri, Deborah Novelli, Markus B Skrifvars, Bjarne Madsen Hardig, Davide Pravettoni, Lidia Staszewsky, Roberto Latini, Angelo Belloli, Giuseppe Ristagno
Background Mechanical chest compression (CC) is currently suggested to deliver sustained high-quality CC in a moving ambulance. This study compared the hemodynamic support provided by a mechanical piston device or manual CC during ambulance transport in a porcine model of cardiopulmonary resuscitation. Methods and Results In a simulated urban ambulance transport, 16 pigs in cardiac arrest were randomized to 18 minutes of mechanical CC with the LUCAS (n=8) or manual CC (n=8). ECG, arterial and right atrial pressure, together with end-tidal CO2 and transthoracic impedance curve were continuously recorded...
January 8, 2019: Journal of the American Heart Association
https://read.qxmd.com/read/30585772/factors-associated-with-the-transfer-decision-in-resuscitated-patients-with-out-of-hospital-cardiac-arrest-presenting-to-a-hospital-with-limited-targeted-temperature-management-capability-in-korea
#11
Sola Kim, Ki Ok Ahn, Young Sun Ro, Sang Do Shin
This study aimed to identify factors associated with the decision to transfer resuscitated patients with out-of-hospital cardiac arrest (OHCA) who were initially examined at hospitals with limited targeted temperature management capability (HLTC) in Korea. We included adult patients with OHCA who were initially transported to HLTC from 2012 to 2015. We limited the study population with OHCA who were admitted or transferred. Potential factors associated with the transfer decision were categorized as patient- or hospital-level characteristics...
December 26, 2018: Therapeutic Hypothermia and Temperature Management
https://read.qxmd.com/read/30580892/field-termination-of-resuscitation-rule-for-refractory-out-of-hospital-cardiac-arrests-in-japan
#12
Yoshikazu Goto, Akira Funada, Tetsuo Maeda, Hirofumi Okada, Yumiko Goto
BACKGROUND: Guidelines for cardiopulmonary resuscitation (CPR) recommend using the universal termination-of-resuscitation (TOR) rule to identify out-of-hospital cardiac arrest (OHCA) patients eligible for field termination of resuscitation, thus avoiding medically futile transportation to the hospital. However, in Japan, emergency medical services (EMS) personnel are forbidden from terminating CPR in the field and transport almost all patients with OHCA to hospitals. We aimed to develop and validate a novel TOR rule to identify patients eligible for field termination of CPR...
December 20, 2018: Journal of Cardiology
https://read.qxmd.com/read/30579349/a-comparison-of-postoperative-outcomes-with-pda-ligation-in-the-or-versus-the-nicu-a-retrospective-cohort-study-on-the-risks-of-transport
#13
Lisa K Lee, Michelle Y Woodfin, Marissa G Vadi, Tristan R Grogan, Phillip J Ross, Richard L Applegate, Marc Iravani
BACKGROUND: Although patent ductus arteriosus (PDA) ligations in the Neonatal Intensive Care Unit (NICU) have been an accepted practice, many are still performed in the Operating Room (OR). Whether avoiding transport leads to improved perioperative outcomes is unclear. Here we aimed to determine whether PDA ligations in the NICU corresponded to higher risk of surgical site infection or mortality and if transport was associated with worsened perioperative outcomes. METHODS: We performed a retrospective cohort study of NICU patients, ≤37 weeks post-menstrual age, undergoing surgical PDA ligation in the NICU or OR...
December 22, 2018: BMC Anesthesiology
https://read.qxmd.com/read/30562597/maternal-out-of-hospital-cardiac-arrest-a-retrospective-observational-study
#14
Olga Maurin, Sabine Lemoine, Daniel Jost, Vincent Lanoë, Aurelien Renard, Stephane Travers, The Paris Fire Brigade Cardiac Arrest Work Group, Frederic Lapostolle, Jean Pierre Tourtier
AIM: Out-of-hospital cardiac arrests (OHCAs) in pregnant women are rare events. In this study, we aimed to describe a cohort of pregnant women who experienced OHCAs in a large urban area, and received treatment by the prehospital teams in a two-tiered emergency response system. METHODS: This retrospective study included pregnant women over 18 years of age who experienced OHCAs. The analysed variables included maternal age, gestational age, variables specific to the rescue system, number of shocks delivered by an automatic external defibrillator, and rates of maternal and neonatal survival...
December 15, 2018: Resuscitation
https://read.qxmd.com/read/30556765/the-safety-and-effectiveness-of-field-nitroglycerin-in-patients-with-suspected-st-elevation-myocardial-infarction
#15
Nichole Bosson, Benjamin Isakson, Jayson A Morgan, Amy H Kaji, Atilla Uner, Katherine Hurley Msn, Timothy D Henry, James T Niemann
OBJECTIVE: While widely used in the treatment of cardiac conditions, only limited data characterize out-of-hospital nitroglycerin (NTG) use. We sought to determine the safety of out-of-hospital sublingual NTG administered for suspected ST-segment elevation myocardial infarction (STEMI) and its effect on the patient's pain score. METHODS: We prospectively identified adult patients with suspected STEMI transported by paramedics to three PCI-capable hospitals in a large urban-suburban EMS system...
December 17, 2018: Prehospital Emergency Care
https://read.qxmd.com/read/30545703/gender-differences-in-the-quality-of-ems-care-nationwide-for-chest-pain-and-out-of-hospital-cardiac-arrest
#16
Jannet F Lewis, Scott L Zeger, Ximin Li, N Clay Mann, Craig D Newgard, Suzanne Haynes, Susan Wood, Mengtao Dai, Alan E Simon, Melissa L McCarthy
BACKGROUND: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system. METHODS: We obtained 2010-2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events...
November 24, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://read.qxmd.com/read/30535030/en-route-resuscitation-utilization-of-ccatt-to-transport-and-stabilize-critically-injured-and-unstable-casualties
#17
Joseph K Maddry, Eric M Ball, Daniel B Cox, Kathleen M Flarity, Vikhyat S Bebarta
Introduction: The U.S. Air Force utilizes specialized Critical Care Air Transport Teams (CCATT) for transporting "stabilized" patients. Given the drawdown of military forces from various areas of operation, recent CCATT operations have increasingly involved the evacuation of unstable and incompletely resuscitated patients from far forward, austere locations. This brief report describes unique cases representative of the evolving CCATT mission and provides future direction for changes in doctrine and educational requirements in preparation for en route combat casualty care...
December 7, 2018: Military Medicine
https://read.qxmd.com/read/30482128/do-out-of-hospital-cardiac-arrest-patients-have-increased-chances-of-survival-when-transported-to-a-cardiac-resuscitation-center
#18
Demis Lipe, Al Giwa, Nicholas D Caputo, Nachiketa Gupta, Joseph Addison, Alexis Cournoyer
Background Patients suffering from an out-of-hospital cardiac arrest are often transported to the closest hospital. Although it has been suggested that these patients be transported to cardiac resuscitation centers, few jurisdictions have acted on this recommendation. To better evaluate the evidence on this subject, a systematic review and meta-analysis of the currently available literature evaluating the association between the destination hospital's capability (cardiac resuscitation center or not) and resuscitation outcomes for adult patients suffering from an out-of-hospital cardiac arrest was performed...
December 4, 2018: Journal of the American Heart Association
https://read.qxmd.com/read/30459025/accidental-hypothermia
#19
Peter Paal, Hermann Brugger, Giacomo Strapazzon
Accidental hypothermia causes profound changes to the body's physiology. After an initial burst of agitation (e.g., 36-37°C), vital functions will slow down with further cooling, until they vanish (e.g. <20-25°C). Thus, a deeply hypothermic person may appear dead, but may still be able to be resuscitated if treated correctly. The hospital use of minimally invasive rewarming for nonarrested, otherwise healthy patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients...
2018: Handbook of Clinical Neurology
https://read.qxmd.com/read/30429631/impact-of-automated-external-defibrillator-as-a-recent-innovation-for-the-resuscitation-of-cardiac-arrest-patients-in-an-urban-city-of-japan
#20
Ikuto Takeuchi, Hiroki Nagasawa, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Youichi Yanagawa
Context/Aims: We retrospectively analyzed the characteristics of prehospital care for cardiopulmonary arrest (CPA) to identify the predictors of a good recovery (GR) among the recent changes in the management of Japanese prehospital care. Settings and Design: This study was a retrospective medical chart review. Subjects and Methods: We reviewed the transportation records written by emergency medical technicians and the characteristics of prehospital management of out-of-hospital (oh) CPA described by the Sunto-Izu Fire Department from April 2016 to March 2017...
July 2018: Journal of Emergencies, Trauma, and Shock
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