Resuscitation
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Randomized Controlled Trial Multicenter Study
The Use of Dispatcher Assistance in Improving the Quality of Cardiopulmonary Resuscitation: A Randomised Controlled Trial.
The introduction of dispatcher assistance (DA) services has led to increased bystander cardiopulmonary resuscitation (CPR) participation rates. However, the extent to which DA improves CPR quality remains unclear. This study aimed to evaluate the efficacy of DA in improving CPR quality among healthcare professionals and laypersons within a multi-ethnic Southeast Asian population. ⋯ DA should be provided to laypersons without valid CPR certification, as well as healthcare professionals. The identification of gaps in the current DA protocol highlights areas where specific changes can be made to improve CPR quality.
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Multicenter Study
Time of on-scene resuscitation in out of-hospital cardiac arrest patients transported without return of spontaneous circulation.
In out-of-hospital cardiac arrest (OHCA), return of spontaneous circulation (ROSC) on scene occurs only in a minority of patients. The optimal duration of resuscitation on scene before transport with ongoing cardiopulmonary resuscitation (CPR) is unknown. ⋯ In OHCA patients transported with ongoing CPR the survival rate significantly declines when time on scene increases.
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Multicenter Study
Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest.
To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest. ⋯ Taking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.
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Multicenter Study
Prognostication after cardiac arrest: Results of an international, multi-professional survey.
We explored preferences for prognostic test performance characteristics and error tolerance in decisions regarding withdrawal or continuation of life-sustaining therapy (LST) after cardiac arrest in a diverse cohort of medical providers. ⋯ Medical providers are comfortable with low acceptable FPR for withdrawal (≤0.1%) and continuation (≤1%) of LST after cardiac arrest. These FPRs may be lower than can be achieved with current prognostic modalities.
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Multicenter Study
Patient and hospital factors predict use of coronary angiography in out-of-hospital cardiac arrest patients.
To describe the association between patient- and hospital-level factors and coronary angiography among patients who suffer out-of-hospital cardiac arrest (OHCA). ⋯ We identified patient- and hospital-level factors that explain some of the variability in the use of coronary angiography for OHCA. Future work should determine which post arrest patients will benefit most from urgent coronary angiography and evaluate knowledge translation strategies to ensure consistent delivery of best practices.