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Latest & greatest articles for cardiac arrest
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Treatment of a patient with acute aortic dissection using extracorporeal cardiopulmonary resuscitation after an outâ€ofâ€hospital cardiacarrest: a case report Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance (...) . While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation. We suspected acute coronary syndrome, so coronary angiography was carried out. Enlargement of ascending aorta was noted. Whole-body enhanced computed tomography was subsequently performed, leading to a final diagnosis of acute aortic dissection.Emergency ascending aorta
Case Report: Toxin-Induced CardiacArrest in Game of Thrones Case Report: Toxin-Induced CardiacArrest in Game of Thrones - CanadiEM Case Report: Toxin-Induced CardiacArrest in Game of Thrones In , by Will Wu December 12, 2017 King Joffrey I Baratheon was found in respiratory distress by his mother, Cersei Lannister, and Jaime Lannister during his wedding to Margaery Tyrell. As this was the wedding for the King of the Seven Kingdoms, numerous guests and bystanders were present. The patient (...) the specific management strategies of toxin-induced cardiacarrest and why we believe the resuscitative attempt (or lack thereof) for Joffrey demonstrated in this case was poor, even for a peasant, let alone the King of the Seven Kingdoms. He would have benefited from receiving proper supportive care with support from a Maester at King’s Landing and from emergency consultation with a Maester with expertise in posions. While the epidemiology of toxin-induced cardiacarrest (TICA) is understudied
Prehospital cooling to improve successful targeted temperature management after cardiacarrest: A randomized controlled trial Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiacarrest (OHCA), but is delivered inconsistently and often with delay.To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival.Pragmatic (...) RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport. The primary outcome was rate of 'successful TTM'; secondary outcomes were rates of applying TTM in hospital, survival with good neurological outcome, pulmonary edema in emergency department, and re-arrest during transport.585 patients were randomized to receive prehospital cooling (n=279) or control
A user-friendly risk-score for predicting in-hospital cardiacarrest among patients admitted with suspected non ST-elevation acute coronary syndrome - The SAFER-score To develop a simple risk-score model for predicting in-hospital cardiacarrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS).Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (...) of in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five variable risk score (age ≥60 years (1 point), ST-T abnormalities (2 points), Killip Class >1 (1 point), heart rate <50 or ≥100bpm (1 point), and systolic blood pressure <100mmHg (2 points) was developed. Model discrimination was good in the derivation cohort (c-statistic 0.72) and temporal validation cohort (c-statistic 0.74), and calibration
Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital CardiacArrest: A Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
, the incidence of sudden cardiacarrest during participation in competitive sports was 0.76 cases per 100,000 athlete-years. The occurrence of sudden cardiacarrest due to structural heart disease was uncommon during participation in competitive sports. (Funded by the National Heart, Lung, and Blood Institute and others.). (...) Sudden CardiacArrest during Participation in Competitive Sports. The incidence of sudden cardiacarrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiacarrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiacarrests that occurred during participation in sports activities within
Association of Public Health Initiatives With Outcomes for Out-of-Hospital CardiacArrest at Home and in Public Locations Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiacarrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor.To describe temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs (...) public location and their association with survival and neurological outcomes.This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.3%] in public) for whom resuscitation was attempted using data from the CardiacArrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina.Patients were stratified by home vs public OHCA. Public health initiatives to improve bystander and first
Continuous versus intermittent neuromuscular blockade in patients during targeted temperature management after resuscitation from cardiacarrest-A randomized, double blinded, double dummy, clinical trial Current guidelines recommend targeted temperature management to improve neurological outcome after cardiacarrest. Evidence regarding an ideal sedative/analgesic regimen including skeletal muscle paralysis is limited.Patients were randomized to either a continuous administration of rocuronium (...) (continuous-NMB-group) or to a continuous administration of saline supplemented by rocuronium bolus administration if demanded (bolus-NMB-group). The primary outcome was the number of shivering episodes. Secondary outcomes included survival and neurological status one year after cardiacarrest, time to awakening, length of stay as well as required cumulative dose of rocuronium, midazolam and fentanyl.Sixty-three patients (32 continuous-NMB-group; 31 bolus-NMB-group) were enrolled. Differences in baseline
in neurobehavioural functioning at 1 year. Conclusion: in comatose children that survived in-hospital cardiacarrest, therapeutic hypothermia did not confer a significant benefit with respect to survival with a good functional outcome at 1 year compared with therapeutic normothermia. Conflicts of interest: several authors disclosed having receiving funds during the study. Funding sources: grants from the National Heart, Lung and Blood Institute and other institutions Critical Commentary Justification: based (...) Hypothermia or normothermia to improve survival after in-hospital cardiacarrest? Hypothermia or normothermia to improve survival after in-hospital cardiacarrest? - Evidencias en pediatría Searching, please wait Show menu Library Management You did not add any article to your library yet. | Search Evidence-Based decision making Evidence-Based decision making Show menu Library Management You did not add any article to your library yet. × User Password Log in × Reset password If you need
Reliability of Administrative Codes for Capturing In-hospital CardiacArrest 28877294 2018 11 13 2380-6591 2 11 2017 Nov 01 JAMA cardiology JAMA Cardiol Administrative Codes for Capturing In-Hospital CardiacArrest. 1275-1277 10.1001/jamacardio.2017.2904 Khera Rohan R Division of Cardiology, University of Texas Southwestern Medical Center, Dallas. Spertus John A JA Saint Luke's Mid America Heart Institute, Kansas City, Missouri. Division of Cardiology, Department of Internal Medicine (...) , University of Missouri-Kansas City, Kansas City. Starks Monique A MA Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. Duke Clinical Research Institute, Durham, North Carolina. Tang Yuanyuan Y Saint Luke's Mid America Heart Institute, Kansas City, Missouri. Bradley Steven M SM Minneapolis Heart Institute, Minneapolis, Minnesota. Girotra Saket S Division of Cardiology, Department of Internal Medicine, University of Iowa, Iowa City. Chan Paul S PS
Association of Neighborhood Demographics With Out-of-Hospital CardiacArrest Treatment and Outcomes: Where You Live May Matter We examined whether resuscitation care and outcomes vary by the racial composition of the neighborhood where out-of-hospital cardiacarrests (OHCAs) occur.To evaluate the association between bystander treatments (cardiopulmonary resuscitation and automatic external defibrillation) and timing of emergency medical services personnel on OHCA outcomes according (...) nonsignificant association between racial composition in a neighborhood and survival.Those with OHCA in predominantly black neighborhoods had the lowest rates of bystander cardiopulmonary resuscitation and automatic external defibrillation use and significantly lower likelihood for survival compared with predominantly white neighborhoods. Improving bystander treatments in these neighborhoods may improve cardiacarrest survival.
Sudden cardiacarrest in hypertrophic cardiomyopathy with dynamic cavity obstruction: The case for a decatecholaminisation strategy Catecholamines are entrenched in the management of shock states. A paradigm shift has pervaded the critical care arena in recent years acknowledging their propensity to cause harm and fuel a 'death-spiral'. We present the case of a 21-year-old male following a witnessed out-of-hospital cardiacarrest who received high-quality cardiopulmonary resuscitation
Temporal Changes in the Racial Gap in Survival After In-Hospital CardiacArrest Previous studies have found marked differences in survival after in-hospital cardiacarrest by race. Whether racial differences in survival have narrowed as overall survival has improved remains unknown.To examine whether racial differences in survival after in-hospital cardiacarrest have narrowed over time and if such differences could be explained by acute resuscitation survival, postresuscitation survival (...) , and/or greater temporal improvement in survival at hospitals with higher proportions of black patients.In this cohort study from Get With the Guidelines-Resuscitation, performed from January 1, 2000, through December 31, 2014, a total of 112 139 patients with in-hospital cardiacarrest who were hospitalized in intensive care units or general inpatient units were studied. Data analysis was performed from April 7, 2015, to May 24, 2017.Race (black or white).The primary outcome was survival to discharge
participants). At autopsy, 27 of 61 decedents (44%) had clinically relevant cardiovascular abnormalities, most frequently atherosclerotic coronary disease or cardiomyopathy.Case identification may be incomplete and may underestimate events, particularly in the early study period. In addition, prerace medical history is unknown in most cases.Deaths and cardiacarrests during the triathlon are not rare; most have occurred in middle-aged and older men. Most sudden deaths in triathletes happened during (...) Death and CardiacArrest in U.S. Triathlon Participants, 1985 to 2016: A Case Series. Reports of race-related triathlon fatalities have raised questions regarding athlete safety.To describe death and cardiacarrest among triathlon participants.Case series.United States.Participants in U.S. triathlon races from 1985 to 2016.Data on deaths and cardiacarrests were assembled from such sources as the U.S. National Registry of Sudden Death in Athletes (which uses news media, Internet searches
Perimortem cesarean delivery and subsequent emergency hysterectomy: new strategy for maternal cardiacarrest Perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiacarrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiacarrest, on the basis of a review
My Heart Goes Boom… ß-Blockers in CardiacArrest My Heart Goes Boom… ß-Blockers in CardiacArrest - CanadiEM My Heart Goes Boom… ß-Blockers in CardiacArrest In , by Sameer Sharif August 15, 2017 A 52-year-old male presents with chest pain. He arrests upon arrival to the Emergency Department and is found to be in ventricular fibrillation. You provide good CPR and defibrillate the patient, and treat him with doses of epinephrine and amiodarone in keeping with the ACLS algorithms. The patient (...) of Ventricular Fibrillation in CardiacArrest Ventricular fibrillation (VF) is the most common arrhythmia associated with out-of-hospital cardiacarrest. 1 Myocardial oxygen consumption increases more than 4-fold in ventricular fibrillation relative to rest. 2 Furthermore, during cardiacarrest and cardiopulmonary resuscitation (CPR), coronary blood flow may be reduced to levels as low as 20-40% of resting values. 3 Epinephrine has been a longstanding treatment for these patients, however, the literature has
Effectiveness of dispatcher training in increasing bystander chest compression for outâ€ofâ€hospital cardiacarrest patients in Japan The Japanese government has developed a standardized training program for emergency call dispatchers to improve their skills in providing oral guidance on chest compression to bystanders who have witnessed out-of-hospital cardiacarrests (OHCAs). This study evaluated the effects of such a training program for emergency call dispatchers in Japan.The analysis
Efficacy and Safety of Combination Therapy of Shenfu Injection and Postresuscitation Bundle in Patients With Return of Spontaneous Circulation After In-Hospital CardiacArrest: A Randomized, Assessor-Blinded, Controlled Trial Postresuscitation care bundle treatment after return of spontaneous circulation in patients experiencing in-hospital cardiacarrest can improve patients' survival and quality of life. The aim of the study was to evaluate the efficacy and safety of combined therapy (...) of Shenfu injection and postresuscitation care bundle in these patients.Prospective, randomized, controlled clinical study.Fifty hospitals in China.Adult patients had experienced in-hospital cardiacarrest between 2012 and 2015.Based on the standardized postresuscitation care bundle treatment, patients were randomized to a Shenfu injection group (Shenfu injection + postresuscitation care bundle) or control group (postresuscitation care bundle) for 14 days or until hospital discharge. In the Shenfu
Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital CardiacArrest: A Randomized Clinical Trial. International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiacarrest for at least 24 hours, but the optimal duration of TTM is uncertain.To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended (...) , standard, 24-hour TTM.This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries. Three hundred fifty-five adult, unconscious patients with out-of-hospital cardiacarrest were enrolled from February 16, 2013, to June 1, 2016, with final follow-up on December 27, 2016.Patients were randomized to TTM (33 ± 1°C) for 48 hours (n = 176
Time to Delivery of an Automated External Defibrillator Using a Drone for Simulated Out-of-Hospital CardiacArrests vs Emergency Medical Services 28609525 2017 07 06 2018 11 13 1538-3598 317 22 2017 06 13 JAMA JAMA Time to Delivery of an Automated External Defibrillator Using a Drone for Simulated Out-of-Hospital CardiacArrests vs Emergency Medical Services. 2332-2334 10.1001/jama.2017.3957 Claesson Andreas A Center for Resuscitation Science, Karolinska Institutet, Stockholm, Sweden. Bäckman (...) , Karolinska Institutet, Stockholm, Sweden. eng Comparative Study Journal Article Research Support, Non-U.S. Gov't United States JAMA 7501160 0098-7484 AIM IM Med Klin Intensivmed Notfmed. 2018 Mar;113(2):141-142 29051969 Aircraft statistics & numerical data Cardiopulmonary Resuscitation Defibrillators statistics & numerical data supply & distribution Electric Countershock instrumentation Emergency Medical Services statistics & numerical data Geographic Information Systems Humans Out-of-Hospital Cardiac