Resuscitation
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Multicenter Study
Initial arterial carbon dioxide tension is associated with neurological outcome after resuscitation from cardiac arrest.
To determine the relationships between partial pressure of arterial carbon dioxide (PaCO2), prescribed minute ventilation (MV), and neurologic outcome in patients resuscitated from cardiac arrest. ⋯ Initial normocarbia was associated with favorable neurological outcome in patients resuscitated from cardiac arrest. This relationship was not seen at subsequent time points. There was no significant association between prescribed MV and PaCO2or neurologic outcome.
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Previous studies have demonstrated significant associations between cardiopulmonary resuscitation (CPR) quality metrics and survival to hospital discharge. No adequately powered study has explored the relationship between location of resuscitation (scene vs. transport) and CPR quality. ⋯ High quality CPR metrics were similar in both (scene and transport) locations of resuscitation. These results suggest that high quality, manual compressions can be performed by prehospital providers regardless of location.
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Knowledge about heart rhythm conversion from non-shockable to shockable rhythm during resuscitation attempt after out-of-hospital cardiac arrest (OHCA) and following chance of survival is limited and inconsistent. ⋯ Converting to shockable rhythm during resuscitation attempt was common and associated with nearly a three-fold higher odds of 30-day survival compared to sustained non-shockable rhythms.
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To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. ⋯ Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs.
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The prognostic effect of early coronary reperfusion therapy with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest due to acute coronary syndrome (ACS) has yet to be clarified. We investigated the relationship between time interval from collapse to start of ECPR (CtoE) and coronary reperfusion (CtoR) time and neurological outcome in patients with cardiac arrest due to ACS. ⋯ A shorter CtoE and CtoR predicts better clinical outcome in patients with ACS undergoing ECPR.