Resuscitation
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Multicenter Study
Association between resuscitation time interval at the scene and neurological outcome after out-of-hospital cardiac arrest in two Asian cities.
It is unclear whether the scene time interval (STI) for cardiopulmonary resuscitation (CPR) is associated with outcomes of out-of-hospital cardiac arrest (OHCA) or not. The present study aimed to determine the association between STI and neurological outcome after OHCA using two large population-based cohorts covering two metropolitan cities in Asia. ⋯ Data from two metropolitan cities demonstrated a positive association between intermediate STI from 8 to 16min and good neurological outcome after OHCA.
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Multicenter Study
The association of body mass index with time to target temperature and outcomes following post-arrest targeted temperature management.
Evidence suggests that more rapid attainment of target temperature (32-34°C) improves neurologic outcome following cardiac arrest and targeted temperature management (TTM). It is unclear to what extent body mass index (BMI) is associated with the time to reach target temperature and subsequent clinical outcomes. ⋯ Target temperature was frequently achieved within 4-6h; as BMI increased, the time to reach target temperature from initiation of TTM was prolonged. There was no significant difference across BMI groups for survival or good neurologic outcome.
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Multicenter Study
The impact of an intervention package promoting effective neonatal resuscitation training in rural China.
To evaluate an intervention package promoting effective neonatal resuscitation training at county level hospitals across China. ⋯ The intervention has not only improved skills of health providers, decreased the mortality and morbidity of birth asphyxia, but also resulted in effective implementation of guidelines and protocols within hospitals.
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Conventional paper-based resuscitation transcripts are notoriously inaccurate, often lacking the precision that is necessary for recording a fast-paced resuscitation. The aim of this study was to evaluate whether a tablet computer-based application could improve upon conventional practices for resuscitation documentation. ⋯ Similar to prior studies, we found that conventional paper-based documentation practices are inaccurate, often misreporting intervention delivery times or missing their delivery entirely. However, our study also demonstrated that a tablet-based documentation method may represent a means to substantially improve resuscitation documentation quality, which could have implications for resuscitation quality improvement and research.
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As organ demand outpaces supply in the United States, donation after cardiac death (DCD) is increasing, and the leading cause of death among donors is now cardiovascular/cerebrovascular disease. Selected patients resuscitated from cardiac arrest may be an under-recognized donor pool. Regional cardiac arrest centers are expected to address organ donation, but there are few guidelines available and the yield from this population is not fully known. ⋯ Post-cardiac arrest patients represent a potential donor pool to help fill the widening gap between organ supply and demand in the United States. Formal multi-modal neurologic assessment may expedite referral to an organ procurement organization. These components should be considered as cardiac arrest center designation criteria.