Resuscitation
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Review Meta Analysis
Impact of adult advanced cardiac life support course participation on patient outcomes-A systematic review and meta-analysis.
The objective of this study was to evaluate the impact of the prior participation of one or more members of the adult resuscitation team in an accredited advanced life support course on patient outcomes (return of spontaneous circulation, survival to discharge, survival to 30 days, and survival to 1 year). ⋯ The inference of this review is that the advanced life support courses have a positive impact upon return of spontaneous circulation and survival to hospital discharge. The data also implies a positive impact upon survival to 30 days of adult cardiac arrest patients.
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Randomized Controlled Trial Multicenter Study
Effects of intra-resuscitation antiarrhythmic administration on rearrest occurrence and intra-resuscitation ECG characteristics in the ROC ALPS trial.
Intra-resuscitation antiarrhythmic drugs may improve resuscitation outcomes, in part by avoiding rearrest, a condition associated with poor out-of-hospital cardiac arrest (OHCA) outcomes. However, antiarrhythmics may also alter defibrillation threshold. The objective of this study was to investigate the relationship between rearrest and intra-resuscitation antiarrhythmic drugs in the context of the Resuscitation Outcomes Consortium (ROC) amiodarone, lidocaine, and placebo (ALPS) trial. ⋯ Rearrest rates did not differ between antiarrhythmic and placebo treatment groups. ECG waveform characteristics were correlated with treatment group and rearrest. Rearrest was inversely associated with survival and neurologic outcomes.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
The introduction of a rapid response system in acute hospitals: A pragmatic stepped wedge cluster randomised controlled trial.
Deterioration of hospitalised patients is often missed, misinterpreted, and mismanaged. Rapid Response Systems (RRSs) have been proposed to solve this problem. This study aimed to investigate the effect of an RRS on the incidence of unexpected death, cardiac arrest with cardiopulmonary resuscitation (CPR), and unplanned intensive care unit (ICU) admission. ⋯ Our intervention had no significant effect on the incidence of unexpected death, cardiac arrest or unplanned ICU admission when adjusted for clustering and study time. We found a lower than expected baseline incidence of unexpected death and cardiac arrest rates which reduced the statistical power significantly in this study.
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Multicenter Study
Identifying barriers to the provision of bystander cardiopulmonary resuscitation (CPR) in high-risk regions: A qualitative review of emergency calls.
Understanding regional variation in bystander cardiopulmonary resuscitation (CPR) is important to improving out-of-hospital cardiac arrest (OHCA) survival. In this study we aimed to identify barriers to providing bystander CPR in regions with low rates of bystander CPR and where OHCA was recognised in the emergency call. ⋯ A range of factors are associated with barriers to delivering bystander CPR even in the presence of dispatcher instructions - some of which are modifiable. To overcome these barriers in high-risk regions, targeted public education needs to provide information about what occurs in an emergency call, how to recognise an OHCA and to improve CPR knowledge and skills.
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Multicenter Study
Long-term risk of seizures among cardiac arrest survivors.
The long-term risk of seizures in cardiac arrest survivors is not established. We hypothesized that survivors of cardiac arrest face an increased long-term risk for seizures. ⋯ The long-term risk of seizures was not elevated in patients with cardiac arrest who survived to hospital discharge without a seizure.