Resuscitation
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We investigated the effect of bystander cardiopulmonary resuscitation (BCPR) with dispatcher assistance (DA) on neurological outcomes based on the response time interval (RTI) of the pre-hospital emergency medical service (EMS) among paediatric patients with out-of-hospital cardiac arrest (OHCA). ⋯ BCPR with DA and a faster EMS RTI were significantly associated with good neurological recovery in paediatric patients with OHCA. When the EMS RTI was delayed, the association of BCPR with DA with good neurological recovery was preserved in paediatric patients with OHCA.
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Japanese emergency medical services (EMS) personnel providing advance life support confirm the absence of a carotid pulse before initiating chest compressions (CCs) in adult out-of-hospital cardiac arrest (OHCA). This study aims to investigate the efficacy of a new protocol facilitating early CCs before definitive cardiac arrest in enhancing the outcomes of OHCA. ⋯ A new EMS protocol facilitating early CCs before definitive cardiac arrest was associated with higher survival of EMS-witnessed OHCA.
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Which haemodynamic variable is the best predictor of neurological outcome remains unclear. We investigated the association of several haemodynamic variables with neurological outcome in CA patients. ⋯ In CA patients admitted to the ICU, low DAP during the first 6 h is an independent predictor of unfavourable neurological outcome at 3 months.
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Prognostication of cardiac arrest patients admitted to the intensive care unit (ICU) may influence treatment decision, but remains challenging. We evaluated the incremental usefulness of routine blood markers from different biological pathways for predicting fatal outcome and neurological deficits in cardiac arrest patients. ⋯ Assessment of routine markers of inflammation/infection and shock provide significant improvements for prognostication of cardiac arrest patients, while cardiac markers did not further improve statistical models. Combination of blood markers and clinical parameters may help to improve initial management decisions in this vulnerable patient population.
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Early cardiopulmonary resuscitation (CPR) and defibrillation with an Automated External Defibrillator (AED) increase survival from out-of-hospital cardiac arrest (OHCA). Although international guidelines recommend the use of AED registries to increase AED use, little is known about implementation. The aim of this paper is to describe the development of a national AED registry, to analyse the coverage and barriers to register AEDs. ⋯ A national AED registry may gather information of AEDs on a national level. Although numbers have doubled between 2013-2016 in Sweden, a large proportion is still non-registered. More awareness of the registry and easier registration process is needed. General AED functionality seems high regardless of registered or non-registered AEDs. A key area for future research may be to use AED-registers to ascertain effectiveness of AED programs in terms of actual patient outcome.