Resuscitation
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Observational Study
External Validation of a Risk Classification at the Emergency Department of Post-cardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management.
There are no established risk classification for post-cardiac arrest syndrome (PCAS) patients at the Emergency Department (ED) undergoing targeted temperature management (TTM). The aim of this study was to externally validate a simplified version of our prognostic score, the "post-Cardiac Arrest Syndrome for Therapeutic hypothermia score" (revised CAST [rCAST]) and estimate the predictive accuracy of the risk classification based on it. ⋯ The rCAST was useful for predicting the neurological outcomes with high accuracy in PCAS patients, and the three grades was developed for a risk classification based on the rCAST.
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Recent work has demonstrated low rates of layperson CPR training across the US. In an attempt to increase rates, some states passed legislation that requires CPR training before high school graduation. We hypothesized laypeople in states with required training would exhibit a greater likelihood of being currently trained in CPR when compared with laypeople in states without required CPR training. ⋯ Individuals were more likely to be currently trained in CPR in states with mandatory CPR training for high school graduation, suggesting a need for additional research on this public policy.
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It is recommended globally that shocks by automated external defibrillators (AEDs) should be delivered immediately when a shockable out-of-hospital cardiac arrest (OHCA) occurs. However, the actual time-interval from collapse to first shock by public-access AED and its impact on subsequent outcome has not been extensively investigated in real-world settings. ⋯ In Japan, earlier shock by public-access AED led to better outcome after bystander-witnessed OHCA with shockable rhythm in public locations. However, the proportion of OHCA patients who received early shock was still low in public locations.
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An investigation of inter-shock timing and electrode placement for double-sequential defibrillation.
Double-Sequential Defibrillation (DSD) is the near-simultaneous use of two defibrillators to treat refractory VF. We hypothesized that (1) risk of DSD-associated defibrillator damage depends on shock vector and (2) the efficacy of DSD depends on inter-shock time. ⋯ University of Alabama at Birmingham Institutional Animal Care and Use Committee (IACUC) Protocol Number 06860.
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The incidence of cardiac arrest (CA) in nursing homes is rising. Our objective was to compare nursing home CAs with at-home CAs in patients aged 65 and over with regard to the CAs' characteristics, the use and characteristics of cardiopulmonary resuscitation (CPR), and the outcome. ⋯ Nursing home residents who experience a CA are less likely to receive CPR from a MICU. If CPR is performed, however, the residents' prognosis is no worse than that of patients treated at home.