Resuscitation
-
It is widely accepted that survival from OHCA may be improved through direct transfer of patients to hospitals with percutaneous coronary intervention (PCI) capability. However, within the New Zealand healthcare system there is limited evidence available to support this. We aimed to compare patient characteristics and outcomes following an out-of-hospital cardiac arrest between those patients transported to hospitals with or without PCI-capability within New Zealand. ⋯ Patient characteristic differences indicate that inequities in healthcare may exist in New Zealand related to age, ethnic group, and rurality. Thirty-day survival was significantly increased in patients conveyed directly to a hospital with PCI-capability.
-
Dispatcher CPR instruction increases the odds of survival. However, many communities do not provide this lifesaving intervention, often citing the barriers of limited personnel, funding, and liability. ⋯ Using a central communication center for instructions allowed us to train and maintain a smaller group of communicators, leading to less cost and more experience for those communicators, while limiting the burden on PSAP dispatchers.
-
Maximum velocity during chest recoil has been proposed as a metric for chest compression quality during cardiopulmonary resuscitation (CPR). This study investigated the relationship of the maximum velocities during compression and recoil phases with compression depth and rate in manual CPR. ⋯ CV and RV were highly correlated with compression depth and compression and recoil times, respectively. Better understanding of the relationship between novel and current quality metrics could help with the interpretation of CPR quality studies.
-
Serum creatinine levels in the post-resuscitative state have been associated with poor prognosis for out-of-hospital cardiac arrest (OHCA). Several studies have focused on kidney dysfunction in the general population, and the results suggested that serum creatinine level elevation or reduction of the estimated glomerular filtration rate (eGFR) are associated with increased risk of death and cardiovascular events. However, it is uncertain whether the serum creatinine levels or eGFR of OHCA patients are related to the incidence of OHCA. The aim of this study was to determine the association between eGFR and the incidence of OHCA. ⋯ In this study, we observed an association between reduced eGFR and the risk of OHCA incidence in a large, community-based population. Future prospective studies are needed to better understand how reduced renal function is associated with OHCA occurrence as well as the impact of intensive risk management and intervention of renal function on OHCA incidence.