Resuscitation
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Observational Study
Bystander Cardiopulmonary Resuscitation and Outcomes of Mass Cardiac Arrests Caused by A Crowd Crush.
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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The guidelines for Advanced Life Support issued by the European Resuscitation Council recommend considering drug delivery through intraosseous access if intravenous access to the vascular bed is not feasible or unsuccessful. Emergency prehospital intraosseous cannulation may theoretically lead to an increased risk of long-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome. Such complications have previously been reported in case reports or small sample case series. We systematically investigated long-term complications potentially associated with intraosseous cannulation using validated Danish health registries. ⋯ Long-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome following prehospital intraosseous cannulation and drug delivery occurred in less than 0.1% of the cases. Our findings indicate that prehospital intraosseous cannulation may be safe across age groups.
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Ambulance call-takers perform the critical role of prompting callers to initiate and continue cardiopulmonary resuscitation (CPR) for patients with suspected out-of-hospital cardiac arrest (OHCA). This study aimed to identify call-taker strategies to address callers' perceptions of CPR 'inappropriateness' (perceiving the patient as dead and beyond help, or as showing signs of life). ⋯ Call-takers used a combination of linguistic features (minimal/symbolic tokens, deontics) and strategies (providing unscripted statements about the context or a rationale for CPR) to overcome barriers of perceived inappropriateness to CPR.
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Bystander cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) has increased in Singapore, Japan, and South Korea following the implementation of several public health, bystander-focused interventions, such as dispatcher-assisted CPR and community CPR training. It is unclear whether bystander CPR prevalence will continue on this trajectory over time. This study aimed to investigate the temporal trends of bystander CPR prevalence over a ten-year period in these three Asian countries. ⋯ This study investigated the trend of bystander CPR over 10 years in three Asian countries. Although the proportion of bystander CPR has increased, it has now plateaued between 50-60 %. Further research is necessary to identify the contributing factors and advance beyond this "invisible ceiling".