Resuscitation
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The management of out-of-hospital cardiac arrest (OHCA) patients requires the coordination of prehospital, in-hospital and post-discharge teams. Data reporting a comprehensive analysis of all costs associated with treating OHCA are scarce. We aimed to describe the total costs (and their components) related to the management of OHCA patients. ⋯ Survival is the main driver of total costs of treating OHCA patients in a large Canadian health system. Inpatient costs accounted for the majority of the total costs; potentially modifiable factors include the number of prehospital teams that arrive to the scene of the arrest and the need for between-hospital transfers after successful resuscitation.
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To mimic chest compression during cardiopulmonary resuscitation (CPR), this study aimed to produce time-resolved 3D (volumetric) reformats of thoracic and upper abdominal tissue movement during incremental closed chest compression/decompression from 0 to 8 to 0 cm. ⋯ The method described could assist CPR researchers and educators in the development and demonstration of effective CPR protocols.
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To test the diagnostic accuracy of ECG-gated coronary computed tomography angiography (CCTA) to detect coronary artery disease (CAD) among survivors of out-of-hospital circulatory arrest (OHCA). ⋯ NCT03111043 https://clinicaltrials.gov/ct2/show/record/NCT03111043.
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Emergency life-saving technicians (ELSTs) are specially trained prehospital medical providers believed to provide better care than basic emergency medical technicians (BEMTs). ELSTs are certified to perform techniques such as administration of advanced airways or adrenaline and are considered to have more knowledge; nevertheless, ELSTs' effectiveness over BEMTs regarding out-of-hospital cardiac arrest (OHCA) remains unclear. We investigated whether the presence of an ELST improves OHCA patient outcomes. ⋯ Compared with the BEMT group, transport by the ELST group was associated with better neurological outcomes in OHCA.
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Real-time measurement of end-tidal carbon dioxide (ETCO2) is used as a non-invasive estimate of cardiac output and perfusion during cardiopulmonary resuscitation (CPR). However, capnograms are often distorted by chest compressions (CCs) and this may affect ETCO2 measurement. The aim of the study was to quantify the effect of CC-artefact on the accuracy of ETCO2 measurements obtained during out-of-hospital manual CPR. ⋯ CC-artefact causes ETCO2 measurement errors in the two studied devices. This suggests that capnometer algorithms may need to be adapted to reliably perform in the presence of CC-artefact during CPR.