Resuscitation
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Countershock outcome prediction using ventricular fibrillation (VF) feature analysis needs undisturbed electrocardiogram (ECG) signals and therefore requires interruption of cardiopulmonary resuscitation (CPR). Features that originate from higher frequency bands of the VF power spectrum may be less affected by CPR artefacts and as such reduce cumulative hands-off intervals. ⋯ The accuracy of shock outcome prediction during CPR could be increased by using filtered ECG features from higher ECG subbands instead of features derived from the main ECG spectrum.
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While lower socioeconomic status is associated with lower level of education and increased incidence of cardiovascular diseases, the impact of socioeconomic status on out-of-hospital cardiac arrest outcomes is unclear. We used residential property values as a proxy for socioeconomic status to determine if there was an association with: (1) bystander CPR rates and (2) survival to hospital discharge for out-of-hospital cardiac arrest. ⋯ This is the largest study showing an association between socioeconomic status and survival, and the first study showing an association with bystander CPR. Our findings suggest targeting CPR training among lower socioeconomic groups.
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Review Comparative Study
Is the combination of vasopressin and epinephrine superior to repeated doses of epinephrine alone in the treatment of cardiac arrest-a systematic review.
No evidence supports vasopressin over epinephrine in cardiac arrest; however animal and some clinical studies support their concurrent use. This systematic review compares the efficacy of vasopressin and epinephrine used together versus repeated doses of epinephrine alone in cardiac arrest. ⋯ This systematic review of the combination of vasopressin and epinephrine found trends towards better ROSC but equivocal effects on survival. At the present time, there is inadequate evidence to advocate the sequential use of vasopressin and epinephrine for cardiac arrest.
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Randomized Controlled Trial
Defibrillation or cardiopulmonary resuscitation first for patients with out-of-hospital cardiac arrests found by paramedics to be in ventricular fibrillation? A randomised control trial.
To determine whether in patients with an ambulance response time of >5min who were in VF cardiac arrest, 3min of CPR before the first defibrillation was more effective than immediate defibrillation in improving survival to hospital discharge. ⋯ For patient in out-of-hospital VF cardiac arrest we found no evidence to support the use of 3min of CPR before the first defibrillation over the accepted practice of immediate defibrillation.