Resuscitation
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Observational Study
Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study.
Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations. ⋯ The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.
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Although the prevention and treatment of cardiovascular conditions have significantly improved over the past decade, whether they have reduced the incidence of sudden cardiac death (SCD) is not known. We sought to evaluate the temporal trends of SCD in a large unselected population. ⋯ Although significant progress to reduce SCD among patients with cardiac conditions was made in the past decade, additional effort should focus on the prevention of SCD in individuals without heart disease.
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Observational Study
Platelet dysfunction after out of hospital cardiac arrest. Results from POHCAR: a prospective observational, cohort study.
Coagulation and platelet function following out of hospital cardiac arrest (OHCA) at admission to a UK cardiology centre were investigated prospectively in this observational feasibility study, and compared to that of patients receiving percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). ⋯ OHCA patients demonstrated reduced thrombin receptor function at hospital admission but overall clot formation dynamics comparable to STEMI patients, indicating no gross coagulopathy post OHCA in our cohort. Hyperfibrinolysis was common both post OHCA and after STEMI. The results of this small feasibility study cannot draw clinical conclusions but will inform power calculations for future studies.
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There is international variation in the rates of bystander cardiopulmonary resuscitation (CPR). 'Bystander CPR' is defined in the Utstein definitions, however, differences in interpretation may contribute to the variation reported. The aim of this cross-sectional survey was to understand how the term 'bystander CPR' is interpreted in Emergency Medical Service (EMS) across Europe, and to contribute to a better definition of 'bystander' for future reference. ⋯ In this survey, the interpretation of 'bystander CPR' varied, particularly when community response systems including laypersons, firefighters, and/or police personnel were involved. It is suggested that the definition of 'bystander CPR' should be revised to reflect changes in treatment of OHCA, and that CPR before arrival of EMS is more accurately described.