Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Scarce resources in disease prevention and emergency medical services (EMS) need to be focused on high-risk areas of out-of-hospital cardiac arrest (OHCA). ⋯ This analysis identified high-risk census tracts and associated census tract-level and case-level characteristics that can be used to target public education efforts to prevent OHCA and to mitigate its occurrence with CPR and automated external defibrillator training. In addition, EMS resources can be redeployed to minimize response times to these census tracts.
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Emergency medical services (EMS) traditionally administer naloxone using a needle. Needleless naloxone may be easier when intravenous (IV) access is difficult and may decrease occupational blood-borne exposure in this high-risk population. Several studies have examined intranasal naloxone, but nebulized naloxone as an alternative needleless route has not been examined in the prehospital setting. ⋯ Nebulized naloxone is a safe and effective needleless alternative for prehospital treatment of suspected opioid overdose in patients with spontaneous respirations.
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Comparative Study
Surrogate markers of transport distance for out-of-hospital cardiac arrest patients.
Transport of out-of-hospital cardiac arrest (OHCA) patients expeditiously to appropriately equipped hospitals is of paramount importance. ⋯ The use of centroids of census blocks via network distance is a valid surrogate for actual location of an OHCA event when calculating transport distance.
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Case Reports
A 35-year-old pregnant woman presenting with sudden cardiac arrest secondary to peripartum cardiomyopathy.
We present a case of successful resuscitation from cardiac arrest after 25 minutes of ventricular fibrillation (VF) secondary to peripartum cardiomyopathy. This case highlights a rare disease, but also, more importantly, the successful use of the five links of survival: early access to 9-1-1, early cardiopulmonary resuscitation (CPR), early defibrillation, early advanced life support, and postresuscitative care. We also demonstrate the importance of high-quality resuscitation practices in order to achieve a successful outcome. ⋯ Nationally, CPR interruptions are often long. We recommend closer attention to uninterrupted 2-minute cycles of CPR, minimizing delays in CPR through training, and a focus on a closely choreographed approach. User review of transthoracic impedance feedback data should play a vital role in a cardiac arrest quality-improvement program.