Articles: cardiac-arrest.
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The laryngeal mask airway (LMAtrade mark airway) provides adequate ventilation and offers a suitable alternative for airway management in patients with cardiac arrest if primary care paramedics do not have intubation skills or are unable to intubate. Training in the use of the LMA usually occurs in the operating room. ⋯ This study reports a 100% training success rate with a mannequin and a 64% success with LMA insertion and ventilation in the field by paramedics among adult out-of-hospital non-traumatic cardiac arrest patients.
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Pediatr Crit Care Me · Apr 2002
Failed extubation after cardiac surgery in young children: Prevalence, pathogenesis, and risk factors.
A total of 212 children
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Previous studies have shown a low but meaningful survival rate in cases of prehospital cardiac arrest with an initial rhythm of asystole. There may be, however, an identifiable subgroup in which resuscitation efforts are futile. This study identified potential field criteria for predicting 100% nonsurvival when the presenting rhythm is asystole in a Basic Life Support-Defibrillation (BLS-D) system. ⋯ In a BLS-D system, there is a very low but measurable survival rate for prehospital asystolic cardiac arrest. CRIs of over 8 minutes were associated with 100% nonsurvival, whereas unwitnessed arrests with no bystander CPR were not. These data add to the growing literature that will help guide ethical decision-making for protocol development in emergency medical services systems.
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National survival rates for out-of-hospital cardiac arrests are less than 5%, and substantial resources are associated with transporting cardiac arrest victims to hospital for emergency department (ED) resuscitation. The low overall survival rate and the identification of predictors of unsuccessful resuscitation have opened debate on the "futility" of transporting such patients to the ED. This study compares the costs of prehospital pronouncement of death to the costs of transporting patients to a hospital ED for physician pronouncement. ⋯ Paramedic pronouncement of death in the field is less costly than transporting patients to hospital for physician pronouncement. Pronouncement in the field requires more paramedic time but less physician time.