Resuscitation
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Observational Study
Firefighters as first-responders in out-of-hospital cardiac arrest- a retrospective study of a time-gain selective dispatch system in the Skåne Region, Sweden.
To analyze the impact of a time-gain selective, first-responder dispatch system on the presence of a shockable initial rhythm (SIR), return of spontaneous circulation (ROSC) and 30-day survival after out-of-hospital cardiac arrest (OHCA). ⋯ In this time-gain selective first-responder dispatch system, a shorter response time was not associated with increased SIR, improved ROSC rate or survival. Process measures differed between the study groups which could account for the observed findings and requires further investigation.
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Characterise how changes in chest compression depth and rate affect variations in end-tidal CO2 (ETCO2) during manual cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA). ⋯ This study quantified the relative importance of chest compression characteristics in terms of their impact on CO2 production during CPR. With ventilation rate standardised, variation in chest compression depth explained variations in ETCO2 better than variation in chest compression rate.
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According to the current resuscitation guidelines, the use of mechanical chest compression devices could be considered under special circumstances like transport with ongoing resuscitation or long-term resuscitation. The aim of this study was to investigate whether survival is improved using mechanical devices under such circumstances. ⋯ Mechanical devices are not associated with better survival when used during transport, but rescuer safety could still be an important argument for their use. Devices are associated with better survival in prolonged resuscitation, but worse survival when a fibrinolytic was used.
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Prior research shows a greater disease burden, lower BCPR rates, and worse outcomes in Black and Hispanic patients after OHCA. Female OHCA patients have lower rates of BCPR compared to men and other survival outcomes vary. The influence of the COVID-19 pandemic on OHCA incidence and outcomes in different health disparity populations is unknown. ⋯ Many OHCA outcomes worsened for Black and Hispanic patients. While some aspects of care worsened for women, their odds of survival improved compared to males.
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Survival after out-of-hospital cardiac arrest (OHCA) remains poor. A physiologically distinct cardiopulmonary resuscitation (CPR) strategy consisting of (1) active compression-decompression CPR and/or automated CPR, (2) an impedance threshold device, and (3) automated controlled elevation of the head and thorax (ACE) has been shown to improve neurological survival significantly versus conventional (C) CPR in animal models. This resuscitation device combination, termed ACE-CPR, is now used clinically. ⋯ Compared with C-CPR controls, rapid initiation of ACE-CPR was associated with a higher likelihood of survival to hospital discharge after OHCA.