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Cardiac arrest management

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13 papers 25 to 100 followers
By Arthur Cronwright Aspiring to best practice always
Gerard B Hannibal
No abstract text is available yet for this article.
April 2015: AACN Advanced Critical Care
Sten Rubertsson, Erik Lindgren, David Smekal, Ollie Östlund, Johan Silfverstolpe, Robert A Lichtveld, Rene Boomars, Björn Ahlstedt, Gunnar Skoog, Robert Kastberg, David Halliwell, Martyn Box, Johan Herlitz, Rolf Karlsten
IMPORTANCE: A strategy using mechanical chest compressions might improve the poor outcome in out-of-hospital cardiac arrest, but such a strategy has not been tested in large clinical trials. OBJECTIVE: To determine whether administering mechanical chest compressions with defibrillation during ongoing compressions (mechanical CPR), compared with manual cardiopulmonary resuscitation (manual CPR), according to guidelines, would improve 4-hour survival. DESIGN, SETTING, AND PARTICIPANTS: Multicenter randomized clinical trial of 2589 patients with out-of-hospital cardiac arrest conducted between January 2008 and February 2013 in 4 Swedish, 1 British, and 1 Dutch ambulance services and their referring hospitals...
January 1, 2014: JAMA: the Journal of the American Medical Association
David Hostler, Elizabeth G Thomas, Scott S Emerson, James Christenson, Ian G Stiell, Jon C Rittenberger, Kyle R Gorman, Blair L Bigham, Clifton W Callaway, Gary M Vilke, Tammy Beaudoin, Sheldon Cheskes, Alan Craig, Daniel P Davis, Andrew Reed, Ahamed Idris, Graham Nichol
BACKGROUND: Out of hospital cardiac arrest (OHCA) is common and lethal. It has been suggested that OHCA witnessed by EMS providers is a predictor of survival because advanced help is immediately available. We examined EMS witnessed OHCA from the Resuscitation Outcomes Consortium (ROC) to determine the effect of EMS witnessed vs. bystander witnessed and unwitnessed OHCA. METHODS: Data were analyzed from a prospective, population-based cohort study in 10 U.S. and Canadian ROC sites...
July 2010: Resuscitation
Ian G Stiell, Siobhan P Brown, James Christenson, Sheldon Cheskes, Graham Nichol, Judy Powell, Blair Bigham, Laurie J Morrison, Jonathan Larsen, Erik Hess, Christian Vaillancourt, Daniel P Davis, Clifton W Callaway
BACKGROUND: The 2010 international guidelines for cardiopulmonary resuscitation recently recommended an increase in the minimum compression depth from 38 to 50 mm, although there are limited human data to support this. We sought to study patterns of cardiopulmonary resuscitation compression depth and their associations with patient outcomes in out-of-hospital cardiac arrest cases treated by the 2005 guideline standards. DESIGN: Prospective cohort. SETTING: Seven U...
April 2012: Critical Care Medicine
Kazuhiko Omori, Shunsuke Sato, Yuka Sumi, Yoshiaki Inoue, Ken Okamoto, Masahiko Uzura, Hiroshi Tanaka
AIM OF THE STUDY: The helicopter emergency medical service (HEMS) was introduced in Japan in 2001, and some cardiopulmonary arrest (CPA) patients are transported using this service. However, it is difficult to maintain continuous and effective manual cardiopulmonary resuscitation (CPR) in flying helicopters. To overcome this problem, the AutoPulse™ system, automated mechanical CPR devices, was induced. We conducted a retrospective study to clarify the efficacy of AutoPulse™ on CPA patients in flying helicopters...
August 2013: Resuscitation
Jesús Ruiz, Unai Ayala, Sofía Ruiz de Gauna, Unai Irusta, Digna González-Otero, Elisabete Aramendi, Erik Alonso, Trygve Eftestøl
OBJECTIVES: Filtering the cardiopulmonary resuscitation (CPR) artifact has been a major approach to minimizing interruptions to CPR for rhythm analysis. However, the effects of these filters on interruptions to CPR have not been evaluated. This study presents the first methodology for directly quantifying the effects of filtering on the uninterrupted CPR time. METHODS: A total of 241 shockable and 634 nonshockable out-of-hospital cardiac arrest records (median duration, 150 seconds) from 248 patients were analyzed...
June 2013: American Journal of Emergency Medicine
Pieter F Fouche, Paul M Simpson, Jason Bendall, Richard E Thomas, David C Cone, Suhail A R Doi
OBJECTIVE: To determine the differences in survival for out-of-hospital advanced airway intervention (AAI) compared with basic airway intervention (BAI) in cardiac arrest. BACKGROUND: AAI is commonly utilized in cardiac arrest in the out-of-hospital setting as a means to secure the airway. Observational studies and clinical trials of AAI suggest that AAI is associated with worse outcomes in terms of survival. No controlled trials exist that compares AAI to BAI. METHODS: We conducted a bias-adjusted meta-analysis on 17 observational studies...
April 2014: Prehospital Emergency Care
Laurie J Morrison, Don Eby, Precilla V Veigas, Cathy Zhan, Alex Kiss, Vince Arcieri, Paul Hoogeveen, Chris Loreto, Michelle Welsford, Tim Dodd, Elma Mooney, Marty Pilkington, Cathy Prowd, Erica Reichl, Jim Scott, Jeanette M Verdon, Tim Waite, Jason E Buick, P Richard Verbeek
BACKGROUND: The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given, and prior studies have suggested the transport rate should fall to 37%. METHODS AND RESULTS: This real-time prospective multi-center implementation trial evaluated the BLS TOR rule for compliance, transport rate and provider and physician comfort...
April 2014: Resuscitation
Leif Rognås, Troels Martin Hansen, Hans Kirkegaard, Else Tønnesen
AIM: The aim of this study was to investigate if an initial ETCO2 value at or below 1.3 kPa can be used as a cut-off value for whether return of spontaneous circulation during pre-hospital cardio-pulmonary resuscitation is achievable or not. MATERIALS AND METHODS: We prospectively registered data according to the Utstein-style template for reporting data from pre-hospital advanced airway management from February 1st 2011 to October 31st 2012. Included were consecutive patients at all ages with pre-hospital cardiac arrest treated by eight anaesthesiologist-staffed pre-hospital critical care teams in the Central Denmark Region...
March 2014: Resuscitation
Francis Kim, Graham Nichol, Charles Maynard, Al Hallstrom, Peter J Kudenchuk, Thomas Rea, Michael K Copass, David Carlbom, Steven Deem, W T Longstreth, Michele Olsufka, Leonard A Cobb
IMPORTANCE: Hospital cooling improves outcome after cardiac arrest, but prehospital cooling immediately after return of spontaneous circulation may result in better outcomes. OBJECTIVE: To determine whether prehospital cooling improves outcomes after resuscitation from cardiac arrest in patients with ventricular fibrillation (VF) and without VF. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial that assigned adults with prehospital cardiac arrest to standard care with or without prehospital cooling, accomplished by infusing up to 2 L of 4°C normal saline as soon as possible following return of spontaneous circulation...
January 1, 2014: JAMA: the Journal of the American Medical Association
Antonio M Dell'anna, Sabino Scolletta, Katia Donadello, Fabio S Taccone
PURPOSE OF REVIEW: Many efforts have been made in the last decades to improve outcome in patients who are successfully resuscitated from sudden cardiac arrest. Despite some advances, postanoxic encephalopathy remains the most common cause of death among those patients and several investigations have focused on early neuroprotection in this setting. RECENT FINDINGS: Therapeutic hypothermia is the only strategy able to provide effective neuroprotection in clinical practice...
June 2014: Current Opinion in Critical Care
Choong Hyun Jo, Gyu Chong Cho, Jung Hwan Ahn, Yoo Seok Park, Chang Hee Lee
BACKGROUND: The 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) recommend that chest compression be rotated every 2 min to prevent rescuer fatigue. However, the quality of chest compression using 2-min switched CPR tends to decrease rapidly due to rescuer fatigue. We aimed to compare the effectiveness of use of 2-min switched CPR and rescuer-limited CPR (the person performing compressions is allowed to switch with another rescuer prior to 2 min if feeling fatigued) in the setting of inhospital cardiac arrest...
July 2015: Emergency Medicine Journal: EMJ
Spyros D Mentzelopoulos, Spyros G Zakynthinos, Maria Tzoufi, Nikos Katsios, Androula Papastylianou, Sotiria Gkisioti, Anastasios Stathopoulos, Androniki Kollintza, Elissavet Stamataki, Charis Roussos
BACKGROUND: Animal data on cardiac arrest showed improved long-term survival with combined vasopressin-epinephrine. In cardiac arrest, cortisol levels are relatively low during and after cardiopulmonary resuscitation. We hypothesized that combined vasopressin-epinephrine and corticosteroid supplementation during and after resuscitation may improve survival in refractory in-hospital cardiac arrest. METHODS: We conducted a single-center, prospective, randomized, double-blind, placebo-controlled, parallel-group trial...
January 12, 2009: Archives of Internal Medicine
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