Resuscitation
-
Defibrillation by public Automated External Defibrillators (AEDs) before EMS arrival is associated with high survival rates. Previous recommendSations suggest that an AED should be placed within a 1-1.5 min "brisk walk" from a cardiac arrest. Current guidelines hold no recommendation. The real-time it takes for a volunteer to retrieve an AED in a public setting has not been studied. ⋯ The median travelling speed of all lay responders dispatched to suspected OHCAs was 2.3 m/s. In densely populated areas the travelling speed was 1.8 m/s. This can be used as support in guidelines for planning placement of AEDs, in simulation studies, as well as in configuration of mobile-based dispatch systems.
-
Randomized Controlled Trial
The influence of prolonged temperature management on acute kidney injury after out-of-hospital cardiac arrest: A post-hoc analysis of the TTH48 trial.
Acute kidney injury (AKI) is common after cardiac arrest and targeted temperature management (TTM). The impact of different lengths of cooling on the development of AKI has not been well studied. In this study of patients included in a randomised controlled trial of TTM at 33 °C for 24 versus 48 h after cardiac arrest (TTH48 trial), we examined the influence of prolonged TTM on AKI and the incidence and factors associated with the development of AKI. We also examined the impact of AKI on survival. ⋯ We did not find any association between prolonged TTM at 33 °C and the risk of AKI during the first seven days in the ICU. AKI is prevalent after cardiac arrest and TTM and occurs in almost half of all ICU admitted patients and more commonly in the elderly, with an increasing BMI and longer arrest duration. AKI after cardiac arrest is an independent predictor of time to death.
-
Cardiac arrests are associated with poor outcomes. The International Liaison Committee on Resuscitation (ILCOR) evaluates resuscitation science and produced, until 2015, five-yearly consensus on science and treatment recommendations (CoSTRs), informing global resuscitation guidelines. We aimed to identify similarities/differences in resuscitation guidelines from ILCOR members, noting concurrence over time, and CoSTRs influence on these guidelines. ⋯ The improved concurrence across the resuscitation guidelines with the CoSTRs suggests that ILCOR members accept and hence incorporate CoSTRs recommendations to inform their own resuscitation guidelines. This is one step towards the development of international universal guidelines for adult and paediatric resuscitation.