Resuscitation
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Observational Study
Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital.
The Neonatal Resuscitation Program (NRP) guidelines recommend positive pressure ventilation (PPV) in the first 60s of life to support perinatal transition in non-breathing newborns. Our aim was to describe the incidence and characteristics of newborn PPV using real-time observation in the delivery unit. ⋯ We observed that most (94%) term newborns spontaneously initiate respirations. In over half observed deliveries receiving PPV, time to initiation of PPV was greater than 60s (longer than recommended). Compliance with current NRP guidelines is difficult, and it's not clear whether it is the recommendations or the training to achieve PPV recommendations that should be modified.
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Bystander compression-only cardiopulmonary resuscitation (CPR) improves survival after out-of-hospital cardiac arrest. To broaden CPR training, 1-2min ultra-brief videos have been disseminated via the Internet and television. Our objective was to determine whether participants passively exposed to a televised ultra-brief video perform CPR better than unexposed controls. ⋯ Passive ultra-brief video training is associated with improved performance of compression-only CPR.
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Observational Study
Disparities in telephone CPR access and timing during out-of-hospital cardiac arrest.
Spanish-only speaking residents in the United States face barriers to receiving potentially life-saving 911 interventions such as Telephone -cardiopulmonary resuscitation (TCPR) instructions. Since 2015, 911 dispatchers have placed an increased emphasis on rapid identification of potential cardiac arrest. The purpose of this study was to describe the utilization and timing of the 911 system during suspected out-of-hospital cardiac arrest (OHCA) by Spanish-speaking callers in Metropolitan Phoenix, Arizona. ⋯ Our study suggests that Hispanic callers under-utilize the 911 system, and when they do call 911, there are significant delays in initiating CPR.
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Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. ⋯ Based on this population-based investigation, bystander CPR was positively associated with long-term survival and appears cost-effective.
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Observational Study
Recognising Out-of-Hospital Cardiac Arrest During Emergency Calls Increases Bystander Cardiopulmonary Resuscitation and Survival.
Initiation of early bystander cardiopulmonary resuscitation (CPR) depends on bystanders' or medical dispatchers' recognition of out-of-hospital cardiac arrest (OHCA). The primary aim of our study was to investigate if OHCA recognition during the emergency call was associated with bystander CPR, return of spontaneous circulation (ROSC), and 30-day survival. Our secondary aim was to identify patient-, setting-, and dispatcher-related predictors of OHCA recognition. ⋯ Recognition of OHCA during emergency calls was positively associated with the provision of bystander CPR, ROSC, and 30-day survival in witnessed OHCA.