Resuscitation
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First pass advanced airway insertion success is associated with fewer adverse events. We sought to compare out-of-hospital endotracheal intubation (ETI) and supraglottic airway (SGA) first-pass success (FPS) rates between adults and children in a national cohort of EMS agencies. ⋯ In this national cohort of out-of-hospital patients, ETI FPS was higher for adults than children. SGA FPS did not significantly vary with age. SGA FPS was higher than ETI FPS at all ages.
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Observational Study
Association of Ventilation with Outcomes from Out-of-Hospital Cardiac Arrest.
To determine the association between bioimpedence-detected ventilation and out-of-hospital cardiac arrest (OHCA) outcomes. ⋯ This novel study shows that ventilation with lung inflation occurs infrequently during 30:2 CPR. Ventilation in ≥50% of pauses was associated with significantly improved rates of ROSC and survival.
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To assess the neurological prognosis of comatose survivors of cardiac arrest by early transcranial Doppler sonography (TCD). ⋯ Data provided by early TCD after ROSC are associated with neurological outcome. The use of TCD could help guide interventions to improve cerebral perfusion after ROSC in patients resuscitated from OHCA.
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Cardiac troponin is routinely tested in the post-cardiac arrest setting, but its utility in identifying ischaemic aetiology and predicting left ventricular systolic dysfunction (LVSD) and survival is not known. ⋯ At both current and several-fold higher thresholds, cTnT does not perform sufficiently well to guide clinical decision-making or predict patient outcomes. Routine post-cardiac arrest testing of cTnT should be reevaluated.
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Although cardiopulmonary resuscitation (CPR) training is recommended in schools, there are few attempts to train all students at universities and no reports showing actual resuscitation actions at emergency settings after the training. We surveyed how many students encountered a collapsed person, whether they performed any resuscitation actions, and any reasons why they could not do any resuscitation actions. ⋯ The incidence rate of encountering OHCA patients was 1.1 per 100 person-years and half of them who encountered a collapsed person performed at least one resuscitation action. Hands-on mass training would encourage university students to perform any resuscitation actions on the emergency scene.