Resuscitation
-
In advanced life support (ALS), time-cycled "loops" of chest compressions form the basis of action. However, the provider must compromise between interrupting compressions and detecting a change in cardiac rhythm. An "optimal" loop duration would best balance these choices. The current international CPR guidelines recommend 2-min loop durations. The aim of this study was to investigate the "optimal" loop duration in patients with initial asystole or pulseless electrical activity (PEA). ⋯ The "optimal" first loop duration may be 4 min in initial PEA and 6-8 min in initial asystole. If secondary PEA/asystole is encountered, 2-min loop duration seems appropriate.
-
To determine the association of neighborhood socioeconomic status (SES) with bystander-initiated cardiopulmonary resuscitation (CPR) and patient outcomes of out of hospital cardiac arrests (OHCAs) in an Asian metropolitan area. ⋯ Patients who experienced an OHCA in low-SES areas were less likely to receive bystander-initiated CPR, and demonstrated worse survival outcomes.
-
Observational Study
Early cardiac catheterization is associated with improved survival in comatose survivors of cardiac arrest without STEMI.
To determine if early cardiac catheterization (CC) is associated with improved survival in comatose patients who are resuscitated after cardiac arrest when electrocardiographic evidence of ST-elevation myocardial infarction (STEMI) is absent. ⋯ In comatose survivors of cardiac arrest without STEMI who are treated with TH, early CC is associated with significantly decreased mortality. The incidence of acute coronary occlusion is high, even when STEMI is not present on the postresuscitation electrocardiogram.
-
Observational Study
Direction of first bystander call for help is associated with outcome from out-of-hospital cardiac arrest.
Preventable bystander delays following out-of-hospital cardiac arrest (OHCA) are common, and include bystanders inappropriately directing their calls for help. ⋯ The frequency of inappropriate bystander calls following OHCA was low, but associated with a reduced likelihood of treatment by EMS and poorer survival outcomes.
-
The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). ⋯ An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.