Resuscitation
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Pulseless electrical activity (PEA) is a frequent initial rhythm in cardiac arrest, and ECG characteristics have been linked to prognosis. The aim of this study was to examine the development of ECG characteristics during advanced life support (ALS) and cardiopulmonary resuscitation (CPR) in cardiac arrest with initial PEA, and to assess any association with survival. ⋯ Changes in ECG characteristics during ALS in cardiac arrest presenting as PEA are related to prognosis. An increase in heart rate was observed in the last 3-6 min before ROSC was obtained.
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Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrest (OHCA), however bystander use remains low. Limited AED training may contribute to infrequent use of these devices, yet no studies have assessed AED training nationally. Given previously documented racial disparities among Latinos in CPR provision and OHCA outcomes, we hypothesized that racial and socioeconomic differences exist in AED training, with Whites having increased training compared to Latinos and higher socioeconomic status being associated with increased training. ⋯ The minority of respondents reported AED training. Whites and Blacks were more likely to be trained than Latinos. Higher educational attainment was associated with an increased likelihood of training. These findings highlight an important opportunity to improve training disparities and layperson response to OHCA.
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Observational Study
Out-of-hospital cardiac arrest with Do-Not-Resuscitate orders signed in hospital: Who are the survivors?
Signing Do-Not-Resuscitate orders is an important element contributing to a worse prognosis for out-of-hospital cardiac arrest (OHCA). However, our data showed that some of those OHCA patients with Do-Not-Resuscitate orders signed in hospital survived to hospital discharge, and even recovered with favorable neurological function. In this study, we described their clinical features and identified those factors that were associated with better outcomes. ⋯ We suggest that some factors should be taken into considerations before Do-Not-Resuscitate decisions are made in hospital for those admitted OHCA patients.