Resuscitation
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Little is known about the long-term trends in the incidence and outcomes of drug overdose out-of-hospital cardiac arrests (OHCA). ⋯ Although the incidence of drug overdose OHCA remained unchanged between 2000 and 2017, the rates of survival have significantly improved.
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This study aimed to assess whether team-based cardiopulmonary resuscitation (CPR) training for emergency medical service (EMS) providers improved the pre-hospital return of spontaneous circulation (ROSC) rates of non-traumatic adult out-of-hospital cardiac arrest (OHCA) patients. ⋯ Team-based CPR training for EMS providers in a large community EMS system improved the pre-hospital ROSC rates of OHCA patients.
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Observational Study
Extracorporeal membrane oxygenation improves outcomes of accidental hypothermia without vital signs: a nationwide observational study.
Patients with accidental hypothermia without vital signs increasingly receive venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, there is limited knowledge regarding the efficacy of this advanced rewarming method. We aimed to determine whether VA-ECMO improved outcomes in patients with accidental hypothermia without vital signs, using a large nationwide inpatient database in Japan. ⋯ VA-ECMO was associated with higher survival and favourable neurological outcomes compared with conventional CPR alone in patients with accidental hypothermia without vital signs.
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Out-of-hospital cardiac arrest (OHCA) is associated with high mortality. Current methods for predicting mortality post-arrest require data unavailable at the time of initial medical contact. We created and validated a risk prediction model for patients experiencing OHCA who achieved return of spontaneous circulation (ROSC) which relies only on objective information routinely obtained at first medical contact. ⋯ CASS accurately predicts mortality in OHCA patients. The model uses only binary, objective clinical data routinely obtained at first medical contact. Early risk stratification may allow identification of more patients in whom timely and aggressive invasive management may improve outcomes.