Resuscitation
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Emergency medical technicians (EMTs) may be subjected to emotional stress during patient treatment/transport. In Japan, dispatched EMTs must attempt resuscitation in all cases of out-of-hospital cardiac arrest (OHCA), including patients with "do not attempt resuscitation" (DNAR) orders and patients whose families do not support resuscitation. We described the characteristics, prevalence, and outcomes of OHCA/DNAR patients, and aimed to identify factors associated with EMT stress when treating them. ⋯ Approximately 30% of EMTs providing resuscitation to OHCA/DNAR patients experienced high levels of stress. Establishment of a prehospital emergency system incorporating physician medical direction and updated guidelines for treating patients with DNAR orders may reduce the psychosocial stress of EMTs.
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Editorial Comment
Mode of transportation of out-of-hospital cardiac arrest patients, the role of community actions and interventions.
The Emergency Medical Services constitutes a critical component in treating patients with out-of-hospital cardiac arrest (OHCA). Activating the EMS system is the first important step in deploying resources, but community involvement in the care of emergent patients is multifaceted and complex. How does the public access EMS services versus other modes of transport remains under investigated; and if the public opts for a different mode of transport to the hospital, how does this affect outcomes?
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Multicenter Study
Sex-related disparities in the in-hospital management of patients with out-of-hospital cardiac arrest.
We investigated sex-related differences in the in-hospital management of patients with out-of-hospital cardiac arrest (OHCA). ⋯ In the PSM cohort, women with OHCA underwent CAG and PCI less frequently than men, regardless of the initial rhythm. However, these sex-related differences narrowed with increasing age. Further studies are needed to confirm the sex-related disparities in the in-hospital management of patients with OHCA.
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Elucidate how physicians formulate a neurological prognosis after cardiac arrest and compare differences between experts and general providers. ⋯ Physicians' cognitive approach to neurologic prognostication is complex and influenced by many factors, including some rarely considered in current research. Understanding these processes better could inform interventions designed to aid physicians in prognostication.
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The present letter to editor comments the manuscript "Sex Disparities in Management and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction in the United States." by Verghese D and coworkers." presenting some comment on sex disparities in treatment and the need for an action on medical school.