Resuscitation
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A crowd crush can lead to respiratory arrest and result in multiple mass cardiac arrests (MCAs), which are often classified as Black Tag in disaster triage. Recently, many laypersons have been commonly trained in compression-only cardiopulmonary resuscitation (CPR) without ventilation support in various communities. This study aims to describe the characteristics of bystander CPR administered and the outcomes of MCAs during the Itaewon crowd crush incident. ⋯ Most MCAs were pronounced deceased, likely due to their classification as Black Tag or delayed response times. Only a small percentage (4.8%) of bystander CPR cases included rescue breathing. An optimized resuscitation protocol for MCAs in crowd crush scenarios should be developed.
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Current Pediatric Advanced Life Support Guidelines recommend maintaining blood pressure (BP) above the 5th percentile for age following return of spontaneous circulation (ROSC) after cardiac arrest (CA). Emerging evidence suggests that targeting higher thresholds, such as the 10th or 25th percentiles, may improve neurologic outcomes. We aimed to evaluate the association between post-ROSC BP thresholds and neurologic outcome, hypothesizing that maintaining mean arterial pressure (MAP) and systolic blood pressure (SBP) above these thresholds would be associated with improved outcomes at hospital discharge. ⋯ After pediatric CA, maintaining MAP above the 5th, 10th, and 25th percentiles and SBP above the 5th percentile during the first 6 h following ROSC was significantly associated with improved neurologic outcomes.