Resuscitation
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Associations between neighbourhood environments and survival outcomes after out-of-hospital cardiac arrests (OHCAs) have been proposed. The purpose of this study was to examine the association between county-level cardiopulmonary resuscitation (CPR) training rates and improvements in survival outcomes after OHCA over 5 years. ⋯ There were moderate associations between county-level CPR training and improvements in good neurological recovery rates over 5 years in the counties.
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Fluoroquinolones have been associated with life-threatening ventricular arrhythmias and even sudden cardiac death. We aimed to assess the temporal relationship of fluoroquinolone use and serious arrhythmias via a case-crossover analysis of a large cohort of serious arrhythmias patients. ⋯ Exposure to fluoroquinolones was substantially associated with serious arrhythmic events, independent of the temporal proximity of fluoroquinolone prescription.
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Observational Study
End Tidal CO2 and Cerebral Oximetry for the Prediction of Return of Spontaneous Circulation During Cardiopulmonary Resuscitation.
End Tidal CO2 (ETCO2) is a reasonable predictor of Return of Spontaneous Circulation (ROSC) in cardiac arrest (CA), though with many limitations. Cerebral Oximetry (CerOx) non-invasively measures brain O2 saturation and correlates with flow. ⋯ Our data shows, both ETCO2 and rSO2 are good predictors of ROSC. We found CerOx superior to ETCO2 in predicting ROSC.
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Manual pulse checks (MP) are an unreliable skill even in the hands of healthcare providers (HCPs). In the context of cardiac arrest, this may translate into inappropriate chest compressions when a pulse is present, or conversely omitting chest compressions when one is absent. To date, no study has assessed the use of B-mode ultrasound (US) for the detection of a carotid pulse. The primary objective of this study was to assess the time required to detect a carotid pulse in live subjects using US compared to the traditional palpation method. ⋯ Carotid pulse detection in live subjects was not slower using US as compared to palpation, and demonstrated higher first attempt success rate and less variability in measurement times. A brief teaching session was sufficient to improve confidence of carotid pulse identification even in those with no previous US training. The preliminary results from this study provide the groundwork for larger studies to evaluate this pulse check method for patients in cardiac arrest.