Susan Mayor
No abstract text is available yet for this article.
December 2, 2014: BMJ: British Medical Journal
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
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...
September 4, 2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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
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
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
Gareth Iacobucci
No abstract text is available yet for this article.
August 5, 2014: BMJ: British Medical Journal
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
Theresa Mariero Olasveengen
No abstract text is available yet for this article.
December 10, 2013: BMJ: British Medical Journal
Gavin D Perkins, Peter Cottrell, Simon Gates
No abstract text is available yet for this article.
April 7, 2014: BMJ: British Medical Journal
Gavin D Perkins, Jerry P Nolan
No abstract text is available yet for this article.
May 29, 2014: BMJ: British Medical Journal
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...
December 10, 2013: BMJ: British Medical Journal
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
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))...
November 20, 2013: Critical Care: the Official Journal of the Critical Care Forum
Kohei Hasegawa, Atsushi Hiraide, Yuchiao Chang, David F M Brown
IMPORTANCE: It is unclear whether advanced airway management such as endotracheal intubation or use of supraglottic airway devices in the prehospital setting improves outcomes following out-of-hospital cardiac arrest (OHCA) compared with conventional bag-valve-mask ventilation. OBJECTIVE: To test the hypothesis that prehospital advanced airway management is associated with favorable outcome after adult OHCA. DESIGN, SETTING, AND PARTICIPANTS: Prospective, nationwide, population-based study (All-Japan Utstein Registry) involving 649,654 consecutive adult patients in Japan who had an OHCA and in whom resuscitation was attempted by emergency responders with subsequent transport to medical institutions from January 2005 through December 2010...
January 16, 2013: JAMA: the Journal of the American Medical Association
Akihito Hagihara, Manabu Hasegawa, Takeru Abe, Takashi Nagata, Yoshifumi Wakata, Shogo Miyazaki
CONTEXT: Epinephrine is widely used in cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA). However, the effectiveness of epinephrine use before hospital arrival has not been established. OBJECTIVE: To evaluate the association between epinephrine use before hospital arrival and short- and long-term mortality in patients with cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS: Prospective, nonrandomized, observational propensity analysis of data from 417 188 OHCAs occurring in 2005-2008 in Japan in which patients aged 18 years or older had an OHCA before arrival of emergency medical service (EMS) personnel, were treated by EMS personnel, and were transported to the hospital...
March 21, 2012: JAMA: the Journal of the American Medical Association
Stephen A Bernard, Karen Smith, Peter Cameron, Kevin Masci, David M Taylor, D James Cooper, Anne-Maree Kelly, William Silvester
BACKGROUND: Therapeutic hypothermia is recommended for the treatment of neurological injury after resuscitation from out-of-hospital cardiac arrest. Laboratory studies have suggested that earlier cooling may be associated with improved neurological outcomes. We hypothesized that induction of therapeutic hypothermia by paramedics before hospital arrival would improve outcome. METHODS AND RESULTS: In a prospective, randomized controlled trial, we assigned adults who had been resuscitated from out-of-hospital cardiac arrest with an initial cardiac rhythm of ventricular fibrillation to either prehospital cooling with a rapid infusion of 2 L of ice-cold lactated Ringer's solution or cooling after hospital admission...
August 17, 2010: Circulation
Gavin D Perkins, Malcolm Woollard, Matthew W Cooke, Charles Deakin, Jessica Horton, Ranjit Lall, Sarah E Lamb, Chris McCabe, Tom Quinn, Anne Slowther, Simon Gates
BACKGROUND: Survival after out-of-hospital cardiac arrest is closely linked to the quality of CPR, but in real life, resuscitation during prehospital care and ambulance transport is often suboptimal. Mechanical chest compression devices deliver consistent chest compressions, are not prone to fatigue and could potentially overcome some of the limitations of manual chest compression. However, there is no high-quality evidence that they improve clinical outcomes, or that they are cost effective...
November 5, 2010: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Patricia J O'Malley, Isabel A Barata, Sally K Snow
The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED...
July 2014: Annals of Emergency Medicine
Nita Khandelwal, Richard E Galgon, Marwan Ali, Aaron M Joffe
BACKGROUND: Placement of advanced airways has been associated with worsened neurologic outcome in survivors of out-of-hospital cardiac arrest. These findings have been attributed to factors such as inexperienced operators, prolonged intubation times and other airway related complications. As an initial step to examine outcomes of advanced airway placement during in-hospital cardiac arrest (IHCA), where immediate assistance and experienced operators are continuously available, we examined whether cardiopulmonary resuscitation efforts affect intubation difficulty...
2014: BMC Anesthesiology
2014-06-18 10:15:07
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