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Latest & greatest articles for cardiac arrest
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Outâ€ofâ€hospital cardiacarrests in the toilet in Japan: a populationâ€based descriptive study This study aimed to reveal the characteristics and outcomes of patients with out-of-hospital cardiacarrests (OHCAs) occurring in the toilet. These traits provide useful clues for the prevention of OHCAs and the improvement of prehospital care for these patients.Out-of-hospital cardiacarrest data were obtained from the population-based, Utstein-style registry in Osaka City, Japan, between 2009 (...) % [220/733] from January to March). Most OHCAs occurring inside the toilet were of cardiac origin (91.5% [671/733]), and 36.2% (265/733) were witnessed by bystanders. The proportion of patients with ventricular fibrillation was 5.2% (38/733) and those receiving shocks by public-access automated external defibrillators was 0.4% (3/733). The proportion of patients with 1-month survival with favorable neurological outcome was 1.9% (14/733).Out-of-hospital cardiacarrests occurring inside the toilet
Cardiacarrest caused by diphenhydramine overdose A 45-year-old man presented to our emergency department with disturbance of consciousness; he had mentioned to his family earlier about a drug overdose. When first responders arrived, he suffered cardiacarrest. Cardiacarrest due to drug overdose was diagnosed.The patient was supported with venoarterial extracorporeal membrane oxygenation. Arterial blood gas showed mixed acidosis, and electrocardiogram showed junctional rhythm and complete
Initial Phase NT-proBNP, but Not Copeptin and High-Sensitivity Cardiac Troponin-T Yielded Diagnostic and Prognostic Information in Addition to Clinical Assessment of Out-of-Hospital CardiacArrest Patients With Documented Ventricular Fibrillation Sudden cardiacarrest (SCA) secondary to ventricular fibrillation (VF) may be due to different cardiac conditions. We investigated whether copeptin, hs-cTnT and NT-proBNP in addition to clinical assessment may help to identify the etiology of SCA (...) and yield prognostic information.EDTA-blood was collected prior to or at hospital admission from patients with SCA of assumed cardiac origin. Clinical data were obtained from hospital records. VF was the primary heart rhythm in 77 patients who initially were divided into 2 groups based on whether they had an ischemic or non-ischemic mechanism as the most likely cause of SCA. They were further divided into 4 groups according to whether or not they had a history of previous heart disease. The patients
Association of Early Postresuscitation Hypotension With Survival to Discharge After Targeted Temperature Management for Pediatric Out-of-Hospital CardiacArrest: Secondary Analysis of a Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
return of spontaneous circulation suggested pulmonary embolism. We administered recombinant tissue plasminogen activator for suspected pulmonary embolism to successfully resuscitate the patient experiencing refractory cardiacarrest despite heparin infusion. After an additional dose of monteplase for persistent shock with remaining right ventricular dilatation on echocardiography, maternal hemodynamics dramatically improved, but fetal heart rate transiently decreased. Targeted temperature management (...) Successful treatment of pulmonary embolismâ€induced cardiacarrest by thrombolysis and targeted temperature management during pregnancy Thrombolysis for pulmonary embolism and targeted temperature management for cardiacarrest are controversial treatments in pregnancy.A 37-year-old woman at 23 weeks gestation presented with persistent dyspnea. She experienced cardiacarrest soon after arrival at the emergency room. Massive right ventricular dilatation on echocardiography during the transient
Early Lactate Elevations Following Resuscitation From Pediatric CardiacArrest Are Associated With Increased Mortality PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Failure of Invasive Airway Placement on the First Attempt Is Associated With Progression to CardiacArrest in Pediatric Acute Respiratory Compromise PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
The profile of Japanese Association for Acute Medicine â€“ outâ€ofâ€hospital cardiacarrest registry in 2014â€“2015 To describe the registry design of the Japanese Association for Acute Medicine - out-of-hospital cardiacarrest (JAAM-OHCA) Registry as well as its profile on hospital information, patient and emergency medical service characteristics, and in-hospital procedures and outcomes among patients with OHCA who were transported to the participating institutions.The special committee (...) participating institutions. The mean age of the patients was 69.2 years, and 61.0% of them were male. The first documented shockable rhythm on arrival of emergency medical services was 9.0%. After hospital arrival, 9.4% underwent defibrillation, 68.9% tracheal intubation, 3.7% extracorporeal cardiopulmonary resuscitation, 3.0% intra-aortic balloon pumping, 6.4% coronary angiography, 3.0% percutaneous coronary intervention, 6.4% targeted temperature management, and 81.1% adrenaline administration
Drug therapy in cardiacarrest: a review of the literature. The aim of this study was to review the literature on human studies of drug therapy in cardiacarrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiacarrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC (...) ) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiacarrest were excluded. The literature search identified a total of 8936 articles. Eighty-eight articles met our inclusion criteria and were included in the review. We
Out-of-hospital cardiacarrest: current concepts. Out-of-hospital cardiacarrest (OHCA) is a leading cause of global mortality. Regional variations in reporting frameworks and survival mean the exact burden of OHCA to public health is unknown. Nevertheless, overall prognosis and neurological outcome are relatively poor following OHCA and have remained almost static for the past three decades. In this Series paper, we explore the aetiology of OHCA. Coronary artery disease remains the predominant (...) cause, but there is a diverse range of other potential cardiac and non-cardiac causes to be aware of. Additionally, we describe how investigators and key stakeholders in resuscitation science have formulated specific Utstein data element domains in an attempt to standardise the definitions and outcomes reported in OHCA research so that management pathways can be improved. Finally, we identify the predictors of survival after OHCA and what primary and secondary prevention strategies can be instigated
Out-of-hospital cardiacarrest: prehospital management. Sudden out-of-hospital cardiacarrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiacarrest, we considered important issues in the prehospital management of cardiacarrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has (...) the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff. However, the best approaches for airway management and the effectiveness of currently used drug treatments are uncertain. Prognostic factors and rules for termination of resuscitation could guide the duration of a resuscitation attempt and decision to transport to hospital. If return of spontaneous circulation is achieved, the focus of treatment shifts
we discuss in-hospital management of patients with post-cardiac-arrest syndrome. In most patients, the most important in-hospital interventions other than routine intensive care are continuous active treatment (in non-comatose and comatose patients and including circulatory support in selected patients), cooling of core temperature to 32-36°C by targeted temperature management for at least 24 h, immediate coronary angiography with or without percutaneous coronary intervention, and delay of final (...) Out-of-hospital cardiacarrest: in-hospital intervention strategies. The prognosis after out-of-hospital cardiacarrest (OHCA) has improved in the past few decades because of advances in interventions used outside and in hospital. About half of patients who have OHCA with initial ventricular tachycardia or ventricular fibrillation and who are admitted to hospital in coma after return of spontaneous circulation will survive to discharge with a reasonable neurological status. In this Series paper
The mechanism of blood flow during chest compressions for cardiacarrest is probably influenced by the patient's chest configuration Mechanical assist devices are sometimes needed during resuscitation efforts of patients with prolonged cardiacarrest. Two such devices, the AutoPulse and the LUCAS, have different mechanisms of action. We propose that the effectiveness of mechanical assist devices is somewhat dependent on the configuration and compliance of the patient's chest wall.A previous (...) study of patients with out-of-hospital cardiacarrest in Arizona reported that survivors were younger and many were observed to have narrow anterior-posterior chest diameters. These observations suggest that the predominant mechanism of blood flow during cardiopulmonary resuscitation of individuals with primary cardiacarrest is influenced by the patient's anterior-posterior chest diameter and compliance. It is proposed that in older individuals with an increased anterior-posterior chest diameter
Comparative Safety of Sulfonylureas and the Risk of Sudden CardiacArrest and Ventricular Arrhythmia To examine the association between individual antidiabetic sulfonylureas and outpatient-originating sudden cardiacarrest and ventricular arrhythmia (SCA/VA).We conducted a retrospective cohort study using 1999-2010 U.S. Medicaid claims from five large states. Exposures were determined by incident use of glyburide, glimepiride, or glipizide. Glipizide served as the reference exposure, as its
Epinephrine in Out-of-Hospital CardiacArrest Epinephrine in Out-of-Hospital CardiacArrest | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Sections Education Fellowships Research Journal Club Events Open Search 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 ?ire (...) continuing good, uninterrupted chest compressions. He gets two more rounds of epi en route and gets 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
CardiacarrestCardiacarrest - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Cardiacarrest Last reviewed: February 2019 Last updated: April 2018 Summary The most common shockable rhythms associated with cardiacarrest are pulseless ventricular tachycardia and ventricular fibrillation. The most common underlying causes are ischaemic heart disease and myocardial infarction. Presentation is usually sudden (...) investigations ECG FBC serum electrolytes ABG cardiac biomarkers toxicology screen CXR echocardiogram coronary angiography cardiac magnetic resonance imaging signal-averaged electrocardiogram (SAECG) electrophysiological study Treatment algorithm INITIAL ACUTE ONGOING Contributors Authors Professor and Department Head of Emergency Medicine Cumming School of Medicine University of Calgary Alberta Health Services Calgary Canada Disclosures EL served as a consultant to the American Heart Association providing
Comparison of the Between the Flags calling criteria to the MEWS, NEWS and the electronic CardiacArrest Risk Triage (eCART) score for the identification of deteriorating ward patients Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration.We sought to compare the Between the Flags (BTF) calling criteria (...) to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic CardiacArrest Risk Triage (eCART) score.Multicenter retrospective analysis of electronic health record data from all patients admitted to five US hospitals from November 2008-August 2013.Cardiacarrest, ICU transfer or death within 24h of a score RESULTS: Overall accuracy was highest for eCART, with an AUC of 0.801 (95% CI 0.799-0.802), followed by NEWS, MEWS and BTF respectively (0.718 [0.716-0.720]; 0.698 [0.696