Resuscitation
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Observational Study
Epidemiology and outcome of emergency medical service witnessed out-of-hospital-cardiac arrest by prodromal symptom: Nationwide observational study.
Although emergency medical service- (EMS-) witnessed out-of-hospital-cardiac arrest (OHCA) has a high survival rate and potential for prevention of progression to cardiac arrest, its characteristics and prodromal symptoms are not well known. The purpose of this study was to investigate the epidemiologic characteristics and outcome of EMS-witnessed OHCA by focusing on its prodromal symptoms. ⋯ About 40% of EMS-witnessed OHCA patients had prodromal symptom before cardiac arrest. In cardiac etiology, patients with cardiac symptoms had the best rate of survival to discharge and good neurological outcome. Promoting public awareness of prodromal symptoms is needed to earn time for preparedness and prevention of progression to cardiac arrest.
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Female out-of-hospital cardiac arrest (OHCA) patients have been reported to be less likely to receive cardiopulmonary resuscitation by bystanders compared with male patients in prehospital settings. However, no clinical studies have investigated gender disparities in the application of public-access automated external defibrillator (AED) pads among OHCA patients in public locations. ⋯ In this population, female OHCA patients of reproductive age (15-49 years) were less likely to receive public-access AED pad application compared with male patients of the same age group.
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A standardised rapid response system (RRS), called the "Between-the-Flags" (BTF) program, was implemented across a large health jurisdiction in Australia in 2010. The impact of RRS on emergency surgical admissions is unknown. ⋯ BTF program was associated with a significant reduction in IHCA and IHCA deaths for emergency surgical patients in prior-non-RRS hospitals but not in the prior-RRS hospitals. The overall hospital and 30-day mortality improved in both cohorts after BTF.
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Observational Study
Type of advanced airway and survival after pediatric out-of-hospital cardiac arrest.
There is a knowledge gap about advanced airway management (AAM) after pediatric out-of-hospital cardiac arrest (OHCA) in the prehospital setting. We assessed which AAM strategy would be associated with an increased chance of survival after pediatric OHCA. ⋯ In Japan, among pediatric OHCA patients, there was no significant difference in one-month survival between prehospital ETI and SGA insertion by EMS personnel. Although an adequately powered randomized controlled trial is needed, EMS personnel may choose their familiar strategy when prehospital AAM was performed during pediatric OHCA.
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The relationship of PaO2 and PaCO2 levels with outcome after cardiac arrest (CA) is controversial. Few studies have analysed both PaO2 and PaCO2 in this setting and the overall exposure to different PaO2 and PaCO2 levels has not been taken into account. ⋯ There was no association between exposure to various levels of PaO2 and PaCO2 and neurological outcome after cardiac arrest.