Resuscitation
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We investigated the national early warning scores (NEWSs) and related outcomes of patients in a tertiary referral center's multidisciplinary emergency department (ED). Patients were further categorized into three groups: triaged directly to intensive care unit (EDICU), triaged to general ward with later ICU admission (EDwardICU) and triaged to general ward (EDward). NEWSs and subsequent outcomes among these sub groups were compared. ⋯ ED-NEWS is independently associated with in-hospital and 30-day mortality with acceptable discrimination capability. Direct and late ICU admissions occurred with comparable NEWSs at admission.
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Multicenter Study Observational Study
Differential effect of mild therapeutic hypothermia depending on the findings of hypoxic encephalopathy on early CT images in patients with post-cardiac arrest syndrome.
The aim of this study was to evaluate the differential effects of mild therapeutic hypothermia (MTH) in post-cardiac arrest syndrome (PCAS) patients depending on the presence/absence of hypoxic encephalopathy (HE) in the early brain CT images obtained before the initiation of MTH. ⋯ The effect of MTH in patients with PCAS differed depending on the presence/absence of evidence of HE on the early CT images.
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Observational Study
Timing of advanced airway management by emergency medical services personnel following out-of-hospital cardiac arrest: A population-based cohort study.
Early prehospital advanced airway management (AAM) by emergency medical services (EMS) personnel has been intended to improve patient outcomes from out-of-hospital cardiac arrest (OHCA). However, few studies examine the effectiveness of early prehospital AAM. We investigated whether early prehospital AAM was associated with functionally favourable survival after adult OHCA. ⋯ Earlier prehospital AAM by EMS personnel was associated with functionally better survival among adult patients who received AAM.
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Little is known regarding the quality of cardiopulmonary resuscitation (CPR) performed by bystanders in out-of-hospital cardiac arrest (OHCA). We sought to determine quality of bystander CPR provided during OHCA using CPR quality data stored by Automated External Defibrillators (AEDs). ⋯ We found that bystanders perform high-quality CPR, with strong adherence rates to existing Resuscitation Guidelines. High-quality CPR is maintained over the first five minutes of resuscitation, but was lowest in the first minute.
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Comparative Study
Comparison of two sedation regimens during targeted temperature management after cardiac arrest.
Although guidelines on post-resuscitation care recommend the use of short-acting agents for sedation during targeted temperature management (TTM) after cardiac arrest (CA), the potential advantages of this strategy have not been clinically demonstrated. ⋯ During TTM following resuscitation from CA, sedation with propofol-remifentanil was associated with significantly earlier awakening and more ventilator-free days as compared with midazolam-fentanyl.