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Latest & greatest articles for cardiac arrest
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Association of Bystander and First-Responder Intervention With Survival After Out-of-Hospital CardiacArrest in North Carolina, 2010-2013. Out-of-hospital cardiacarrest is associated with low survival, but early cardiopulmonary resuscitation (CPR) and defibrillation can improve outcomes if more widely adopted.To examine temporal changes in bystander and first-responder resuscitation efforts before arrival of the emergency medical services (EMS) following statewide initiatives to improve (...) bystander and first-responder efforts in North Carolina from 2010-2013 and to examine the association between bystander and first-responder resuscitation efforts and survival and neurological outcome.We studied 4961 patients with out-of-hospital cardiacarrest for whom resuscitation was attempted and who were identified through the CardiacArrest Registry to Enhance Survival (2010-2013). First responders were dispatched police officers, firefighters, rescue squad, or life-saving crew trained to perform
) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001).A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiacarrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.). (...) Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiacarrest. Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiacarrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital
Early cardiopulmonary resuscitation in out-of-hospital cardiacarrest. Three million people in Sweden are trained in cardiopulmonary resuscitation (CPR). Whether this training increases the frequency of bystander CPR or the survival rate among persons who have out-of-hospital cardiacarrests has been questioned.We analyzed a total of 30,381 out-of-hospital cardiacarrests witnessed in Sweden from January 1, 1990, through December 31, 2011, to determine whether CPR was performed before (...) the arrival of emergency medical services (EMS) and whether early CPR was correlated with survival.CPR was performed before the arrival of EMS in 15,512 cases (51.1%) and was not performed before the arrival of EMS in 14,869 cases (48.9%). The 30-day survival rate was 10.5% when CPR was performed before EMS arrival versus 4.0% when CPR was not performed before EMS arrival (P<0.001). When adjustment was made for a propensity score (which included the variables of age, sex, location of cardiacarrest, cause
CardiacArrest Emergency Response in Hospitals Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other (...) not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: CardiacArrest Emergency Response in Hospitals: Clinical Effectiveness
Survival After Out-of-Hospital CardiacArrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival Survival after out-of-hospital cardiacarrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival.Using data from the nationwide Danish CardiacArrest Registry (2001─2011), we identified 21 480 patients ≥18 (...) years old with a presumed cardiac-caused out-of-hospital cardiacarrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary
Therapeutic hypothermia after out-of-hospital cardiacarrest in children. Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiacarrest, but data about this intervention in children are limited.We conducted this trial of two targeted temperature interventions at 38 children's hospitals involving children who remained unconscious after out-of-hospital cardiacarrest. Within 6 hours after the return of circulation, comatose patients who were older than (...) 2 days and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or therapeutic normothermia (target temperature, 36.8°C). The primary efficacy outcome, survival at 12 months after cardiacarrest with a Vineland Adaptive Behavior Scales, second edition (VABS-II), score of 70 or higher (on a scale from 20 to 160, with higher scores indicating better function), was evaluated among patients with a VABS-II score of at least 70 before cardiac
Mechanical versus manual chest compression for out-of-hospital cardiacarrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. 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.The pre-hospital randomised assessment of a mechanical compression device in cardiacarrest (PARAMEDIC) trial was a pragmatic, cluster-randomised open-label trial including adults with non-traumatic, out-of-hospital cardiacarrest from four UK Ambulance Services (West Midlands, North East England, Wales, South Central). 91 urban and semi-urban ambulance stations were selected for participation. Clusters were ambulance service vehicles, which were randomly assigned (1:2) to LUCAS
2015LancetControlled trial quality: predicted high
Outcome after resuscitation beyond 30 minutes in drowned children with cardiacarrest and hypothermia: Dutch nationwide retrospective cohort study. To evaluate the outcome of drowned children with cardiacarrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation.Nationwide retrospective cohort study.Emergency departments and paediatric intensive care units of the eight (...) university medical centres in the Netherlands.Children aged up to 16 with cardiacarrest and hypothermia after drowning, who presented at emergency departments and/or were admitted to intensive care.Survival and neurological outcome one year after the drowning incident. Poor outcome was defined as death or survival in a vegetative state or with severe neurological disability (paediatric cerebral performance category (PCPC) ≥ 4).From 1993 to 2012, 160 children presented with cardiacarrest and hypothermia
were also compared. Elderly patients had a higher cardiacarrest rate (2.2 vs 1.0 per 1,000 ward admissions; p<0.001) and in-hospital mortality (2.9% vs 0.7%; p<0.001) than nonelderly patients. Within 4 hours of cardiacarrest, elderly patients had significantly lower mean heart rate (88 vs 99 beats/min; p<0.001), diastolic blood pressure (60 vs 66 mm Hg; p=0.007), shock index (0.82 vs 0.93; p<0.001), and Modified Early Warning Score (2.6 vs 3.3; p<0.001) and higher pulse pressure index (0.45 vs (...) Differences in Vital Signs Between Elderly and Nonelderly Patients Prior to Ward CardiacArrest Vital signs and composite scores, such as the Modified Early Warning Score, are used to identify high-risk ward patients and trigger rapid response teams. Although age-related vital sign changes are known to occur, little is known about the differences in vital signs between elderly and nonelderly patients prior to ward cardiacarrest. We aimed to compare the accuracy of vital signs for detecting
with the system range in price from £318.27 to £637.94. The single-use start-up kit is £235.87. A number of consumables, accessories and options are also available. The UK supplier, Delta Surgical, may provide Thermogard XP control units free of charge to the NHS, based on commitment to purchase disposable components. No published evidence on the resource consequences of Thermogard XP was identified. Introduction Introduction Cardiacarrest is caused by a loss of heart function. The heart stops pumping blood (...) around the body, leading to loss of consciousness and death unless emergency resuscitation is given and the heart can be restarted to achieve the return of spontaneous circulation (ROSC). Post-cardiacarrest syndrome can occur after ROSC and involves multiple systems. It reflects a state of whole-body ischaemia (restricted blood supply) and subsequent reperfusion. Its severity depends on the duration and cause of cardiacarrest, often reflecting the underlying condition, pre-existing co-morbidities
Mechanical versus manual chest compression for out-of-hospital cardiacarrest (PARAMEDIC): a pragmatic, cluster randomised control trial. 28979419 2017 10 05 1751-1437 16 3 2015 Aug Journal of the Intensive Care Society J Intensive Care Soc Mechanical versus manual chest compression for out-of-hospital cardiacarrest (PARAMEDIC): a pragmatic, cluster randomised control trial. 241-243 10.1177/1751143715591402 eng Journal Article Review 2015 06 30 England J Intensive Care Soc 101538668 1751-1437
Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital” 2013 X X X X “Impact of Percutaneous Coronary Intervention Performance Reporting on Cardiac Resuscitation Centers” 2013 X AHA indicates American Heart Association; CQI, continuous quality improvement; EMS, emergency medical services; and IOM, Institute of Medicine. Table 4. Ongoing AHA Initiatives Related to the 2015 IOM CardiacArrest Recommendations IOM Recommendations Ongoing AHA Initiative 1. National (...) closely aligned with the requirements for resuscitation centers for adult nonpregnant cardiacarrest. ACC/AHA indicates American College of Cardiology/American Heart Association; ACLS, advanced cardiac life support; AED, automated external defibrillator; CPR, cardiopulmonary resuscitation; EMS, emergency medical services; EP, electrophysiology; ICD, implantable cardioverter-defibrillator; OHCA, out-of-hospital cardiacarrest; PPCI, primary percutaneous coronary intervention; and STEMI, ST-segment
Epinephrine in Out?of?Hospital CardiacArrest Emergency Medicine > Journal Club > Archive > January 2015 Toggle navigation January 2015 Epinephrine in Out-of‐Hospital CardiacArrest Vignette You are doing an EMS ride‐along during your EMS elective and get a call for a 70-year old male in cardiacarrest. The paramedic hits the lights and sirens and you're on scene in five minutes. The fire department has already arrived and CPR is in progress. They tell you that the patient was watching TV (...) a pulse back. On arrival to the ED he has a pulse, is mildly hypotensive, but has no spontaneous breaths and his pupils are fixed and dilated. You know that giving epinephrine in cardiacarrest is the standard of care, but wonder what effect it really has: does it improve ROSC, and if so does it actually improve neurologic function down the road. You wonder if their is really any evidence to support its use at all. You head to the computer and start searching... PICO Question Population: Adult
, et al. Predictors of survival from out-of-hospital cardiacarrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3:63-81. 3. Berg RA, Hemphill R, Abella BS, et al. Part 5: adult basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S685-705. 4. Brooks SC, Bigham BL, Morrison LJ. Mechanical versus manual chest compressions for cardiacarrest. Cochrane Database Syst Rev (...) Do Mechanical Devices Improve Return of Spontaneous Circulation Over Manual Chest Compressions in Out-of-Hospital CardiacArrest? Systematic Review Snapshot TAKE-HOME MESSAGE Data are inadequate to determine whether recent devices (either load-distributing band or piston-driven) confer bene?t or harm, though early trial data suggest they do not. Do Mechanical Devices Improve Return of Spontaneous Circulation Over Manual Chest Compressions in Out-of-Hospital CardiacArrest? EBEM Commentators
Development of a prompt model for predicting neurological outcomes in patients with return of spontaneous circulation from outâ€ofâ€hospital cardiacarrest Early prediction of the neurological outcomes of patients with out-of-hospital cardiacarrest is important to select the optimal clinical management. We hypothesized that clinical data recorded at the site of cardiopulmonary resuscitation would be clinically useful.This retrospective cohort study included patients with return (...) , specificity, and accuracy were 80%, 92%, and 90%, respectively, for the validation dataset (total, n = 201; favourable outcome, n = 25).The 6-month neurological outcomes can be predicted in patients resuscitated from out-of-hospital cardiacarrest using clinical parameters that can be easily recorded at the site of cardiopulmonary resuscitation.
Normothermia versus Therapeutic Hypothermia for Adult Patients after CardiacArrest TITLE: Normothermia versus Therapeutic Hypothermia for Adult Patients after CardiacArrest: Clinical Evidence DATE: 26 August 2014 RESEARCH QUESTION What is the clinical evidence for neurological benefits or harms of maintaining normothermia versus induction of therapeutic hypothermia in adult patients following cardiacarrest? KEY FINDINGS Six systematic reviews and one randomized controlled trial were (...) identified regarding the comparative neurological benefits and harms of maintaining normothermia versus induction of therapeutic hypothermia in adult patients following cardiacarrest. METHODS A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2014, Issue 8), University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. Methodological filters were